肝细胞癌合并门静脉癌栓与AFP-L3%相关性研究  

Correlation between Lens Culinaris Agglutinin-reactive A-Fetoprotein(AFP-L3%) with Portal Vein Tumor Thrombosis in Hepatocellular Carcinoma

作　　者：陈祖华[1] 陈瑶[1] 高智峰[1] 徐爱芳[2] 李运江[2] 

机构地区：[1]浙江中医药大学附属第二医院,杭州310005 [2]杭州市第六人民医院

出　　处：《医学研究杂志》2012年第7期113-116,共4页Journal of Medical Research

摘　　要：目的探讨肝细胞肝癌(hepatocellular carcinoma,HCC)伴门静脉癌栓(portal vein tumor thrombosis,PVTT)与AFP-L3%相关性。方法将治疗前15天内完成多排螺旋CT(MSCT)检查和AFP-L3%检测的HCC患者100例作为研究对象。根据AFP-L3%检测结果,分为阳性组(≥10%)和阴性组(<10%)。PVTT诊断和累及范围通过多排螺旋CT增强3期检查。根据PVTT累及范围分为Ⅳ级:Ⅰ级为门静脉一级分支,即门静脉左或右干(LPV、RPV)有瘤栓;Ⅱ级LPV或RPV加门静脉主干(TPV)被侵犯;Ⅲ级LPV、RPV和TPV均受累;Ⅳ级PVTT加脾静脉或肠系膜上静脉被累及,合并肝外转移;并计算各级癌栓AFP-L3%均值。AFP-L3采用装有偶联了小扁豆凝集素(LCA)的微量离心柱分离甲胎蛋白,利用化学发光法检测AFP和AFP-L3,并计算AFP-L3占AFP含量的百分比。采用SPSS17.0软件进行统计学分析。结果在100例HCC患者中,阳性组71例(71%),其中合并PVTT 41例(57.7%);阴性组29例(29%),合并PVTT 8例(27.6%)。阳性组较阴性组易侵犯门静脉形成PVTT(P<0.01)。根据PVTT累及范围分级,Ⅰ级16例、Ⅱ级13例、Ⅲ级11例及Ⅳ级9例。Ⅰ～Ⅳ级AFP-L3%均值分别为14.5、18.3、20.1、26.3。PVTT各级间的AFP-L3%均值有统计学意义(P<0.05)。结论 AFP-L3%阳性HCC患者易侵犯门静脉形成PVTT,并且AFP-L3%越高PVTT累及范围越广。Objective To investigate correlation between Lens culinaris agglutinin - reactive a - Fetoprotein（ AFP - L3% ） and por- tal vein tumor thrombosis （PVTT） in hepatocellular carcinoma（ HCC）. Methods A total of 100 patients with HCC who were examinated AFP - L3% and multidetector CT（MDCT） in 15 days before treatment were regarded as research object. AFP - L3 of 10% or higher was judged to the positive group,otherwise, to the negative group. AFP- L3% were acquired by lectin- affinity electrophoresis coupled with antibody - affinity blotting, and expressed as AFP - L3 percentage of total AFP. CT features of HCC were evaluated PVTT and were divid- ed into 4 stages according to infringing scope of PVTT： stage I of the first branch of the left or right portal vein was invaded by tumor thrombosis ; stage Ⅱ of the trunk and first branch of the left or right portal vein were invaded; stage Ⅲ of the trunk and first branch of the left and right portal vein; stage Ⅳ of Included invasion of superior mesenteric vein or splenic vein, or PVTT merging extraheptatic metas- tasis. PVTT and infringing scope of PVTT were compared between AFP - L3 - positive and negative HCC. Results Totally 71 patients （71%） in positive group, 29 patients （29%） in negative group were found in 100 cases of HCC. The rate of 41 cases （57.7%）with PVTT in the positive group was higher than that of 8 cases（27.6% ） with PVTT in negative group（P 〈 0. 01 ） , which showed that AFP - L3 - positive HCC violated the portal vein and formed PVTT than negative noore easily. PVTT classification and the corresponding mean of AFP - L3% were stage I in 16 cases,stage Ⅱ in 13 cases,stage Ⅲ in 11 cases, stage Ⅳ in 9 cases with mean of 14.5,18.3,20.1,26. 3, respecively. The AFP - L3 % mean of the different classes of PVTT were statistically significant （P 〈 0.05 ）. Conclusion AFP - L3 % - positive HCC patients violate the portal vein and form PVTT easily. The higher the AFP- L3% is,the broader PVTT involve scope.

关 键 词：肝细胞癌 门静脉癌栓 AFP-L3 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]