Clinical relevance of increased serum preneoplastic antigen in hepatitis C-related hepatocellular carcinoma  

作　　者：Satoyoshi Yamashita Akira Kato Toshitaka Akatsuka Takashi Sawada Tomohide Asai Noriyuki Koyama Kiwamu Okita 

机构地区：[1]Department of Gastroenterology and Hepatology,Japan Community Health Care Organization Shimonoseki Medical Center,Shimonoseki,Yamaguchi 7500061,Japan [2]Department of Physiology,Faculty of Medicine,Saitama Medical University,Iruma-gun,Saitama 3500495,Japan [3]Research and Development Division,Sekisui Medical Company Limited,Ryugasaki,Ibaraki 3010852,Japan [4]Clinical Research Department,Eidia Company Limited,Chiyoda-ku,Tokyo 1010032,Japan [5]Eisai Company Limited,Shinjuku-ku,Tokyo 1600812,Japan [6]Department of Internal Medicine,Shunan Memorial Hospital,Kudamatsu,Yamaguchi 7440033,Japan

出　　处：《World Journal of Gastroenterology》2020年第13期1463-1473,共11页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND The prognosis of hepatocellular carcinoma(HCC)patients remains poor despite advances in treatment modalities and diagnosis.It is important to identify useful markers for the early detection of HCC in patients.Preneoplastic antigen(PNA),originally reported in a rat carcinogenesis model,is increased in the tissues and serum of HCC patients.AIM To determine the diagnostic value of PNA for discriminating HCC and to characterize PNA-positive HCC.METHODS Patients with hepatitis C virus(HCV)-related hepatic disorders were prospectively enrolled in this study,which included patients with hepatitis,with cirrhosis,and with HCC.A novel enzyme-linked immunosorbent assay was developed to measure serum PNA concentrations in patients.RESULTS Serum PNA concentrations were measured in 89 controls and 141 patients with HCV infections(50 hepatitis,44 cirrhosis,and 47 HCC).Compared with control and non-HCC patients,PNA was increased in HCC.On receiver operating characteristic curve analysis,the sensitivity of PNA was similar to the HCC markers des-γ-carboxy-prothrombin(DCP)andα-fetoprotein(AFP),but the specificity of PNA was lower.There was no correlation between PNA and AFP and a significant but weak correlation between PNA and DCP in HCC patients.Importantly,the correlations with biochemical markers were completely different for PNA,AFP,and DCP;glutamyl transpeptidase was highly correlated with PNA,but not with AFP or DCP,and was significantly higher in PNA-high patients than in PNA-low patients with HCV-related HCC.CONCLUSION PNA may have the potential to diagnose a novel type of HCC in which glutamyl transpeptidase is positively expressed but AFP or DCP is weakly or negatively expressed.

关 键 词：SERUM preneoplastic ANTIGEN Hepatitis C virus HEPATOCELLULAR carcinoma Des-γ-carboxy-prothrombin α-Fetoprotein Sensitivity SPECIFICITY 

分 类 号：R512.63[医药卫生—内科学] R735.7[医药卫生—临床医学]