Hepatosellüler karsinomada α−fetoprotein ve plazma anormal proteinin tanisal degeri
Diagnostic value of α−fetoprotein and plasma abnormal prothrombin in hepatocellular carcinoma
- Ana Sayfa
- Sayılar
- Hepatosellüler karsinomada α−fetoprotein ve plazma anormal proteinin tanisal degeri...
Özet
Giris ve amaç: “Protein induced by vitamin K absence or antagonist II” hepatosellüler karsinoma tanisinda kullanilan yeni sensitif bir belirleyicidir. Alfa-fetoprotein ile birlikte kullanildiginda sensitivitesi daha da artmaktadir. Bizde bu çalismada sirozlu ve ve hepatomali hastalarda kontrol grubuna göre alfa-fetoprotein ve plazma “protein induced by vitamin K absence or antagonist II” düzeylerini ölçmeyi amaçladik. Gereç ve yöntem: Çalismaya 90 hasta alindi. Bu hastalarin kadin / erkek orani 28/62 idi. Hastalar siroz, hepatosellüler karsinoma ve kontrol grubu olarak degerlendirmeye alindi. Bu hastalardan 62’si hepatoma, 20‘si siroz ve 18 kontrol grubundan olusmaktaydi. Hepatosellüler karsinoma grubunda 19 kadin, 43 erkek, siroz grubunda 9 kadin 11 erkek ve kontrol grubunda 7 kadin 11 erkek bulunmaktaydi. Tümör büyüklügü ve sayisi ile alfa-fetoprotein ve “protein induced by vitamin K absence or antagonist II” düzeyleri arasindaki iliski degerlendirildi. Tüm hastalarin alfa-fetoprotein ve “protein induced by vitamin K absence or antagonist II” düzeylerine bakildi. Çalismanin istatistiksel analizleri için “students t testi”, “Chi – kare” ve “Duncan” testi uygulandi. Bulgular: Gruplar arasinda yas ve cins bakimindan istatistiksel olarak anlamli fark yoktu. Hepatosellüler karsinoma’li hasta grubunda hem alfa-fetoprotein hem de hem de “protein induced by vitamin K absence or antagonist II” düzeyleri siroz ve kontrol grubuna göre anlamli oranda yüksek bulundu. “protein induced by vitamin K absence or antagonist II”‘nin sensitivitesi % 92.3 ve spesifitesi % 90.9 olarak tespit edildi. Ayrica alfa-fetoprotein normal “protein induced by vitamin K absence or antagonist II” yüksek olgularin orani da % 41.9 bulundu. Sonuç: “Protein induced by vitamin K absence or antagonist II”, alfa-fetoprotein kadar duyarli bir yöntemdir. Sensitivitesi yüksek olup hepatosellüler karsinoma’da erken tani, tarama ve nüksleri saptamada yararli bir yöntem gibi görünmektedir. Alfa-fetoprotein ile kombine kullanildiginda ve yeni immunassay yöntemleri ile saptanirsa küçük tümörleri de saptamada etkili bir yöntem olacaktir.
Abstract
Background and aim: Protein induced by vitamin K absence or antagonist II is a new and sensitive indicator of hepatocelluler carcinoma and its sensitivity is higher when performed with alpha- fetoprotein. The aim of this study was to measure sensitivity and specifity of protein induced by vitamin K absence or antagonist II in hepatocelluler carcinoma and to compare the diagnostic value of these methods. Material and methods: Ninety (28 female and 62 male) subjects were included in the study and were divided into three groups: hepatocelluler carcinoma (62 patients), cirrhosis (20 patients) and controls (18 cases). Alpha- fetoprotein and protein induced by vitamin K absence or antagonist II were measured in all patients. Student’s t, Chi square and Duncan tests were used for statsitical analysis. Results: In hepatocelluler carcinoma patients alphafetoprotein and protein induced by vitamin K absence or antagonist II levels were significantly higher than controls and cirrhosis. Sensitivity and specificitiy of protein induced by vitamin K absence or antagonist II were 92.3 %, and 90.9 % respectively. Abnormal protein induced by vitamin K absence or antagonist II levels were found in 41.9 % patients with normal alpha- fetoprotein levels. Conclusions: According to our findings protein induced by vitamin K absence or antagonist II may be useful in the diagnosis, screening and detection of relapse in hepatocelluler carcinoma. It also appears to be useful in diagnosing small hepatocelluler carcinoma when used with new immunoassay methods and alpha- fetoprotein.
