去羧基凝血酶原之測定及其對肝疾病之診斷意義

以一種簡單的實驗室方法，測定255位血漿去羧基凝血原（DCP）。其中59位為健康常人，100位為原發性肝細胞癌，33位為肝硬變，16位為肝炎，11位為轉移性肝癌及36位為服用抗維生素K藥物之患者。健康常人之DCP值在0-6 VGH u/l之間（平均值為3.02VGH u/I）；而服用抗維生素K之病患之DCP值在73-323 VGH u/l之間（平均為2/4.20 VGH u/l）。若以DCP值大於10 VGH u/l為不正常，則有約62%肝癌病患，其DCP值不正常。在良性之肝硬變及肝炎患者中，其DCP值均為正常：而在轉移性肝癌之病患中，有36.36%具不正常之DCP值。由以上資料顯示，良性之肝疾病患者，無一人有高DCP值者。因此，當一位病人具有正常之DCP值時，雖然不能排除其肝癌之可能性，但當在一臨床上診斷為良性肝病而具有高DCP值之病人中，應高度懷疑已有肝癌之可能性，此亦為DCP在臨床上之重要診斷特性及價值。

關鍵字

去羧基凝血酶原；原發性肝細胞癌；肝疾病

並列摘要

A simple and practical laboratory method to assay plasma des-gamma-carboxyprothrombin (DCP) was applied in 255 subjects. Among them, 59 were healthy subjects, 100 had primary hepatocellular carcinoma (PHC), 33 had cirrhosis of liver, 16 had hepatitis, 11 had metastatic carcinoma of liver, and 36 subjects previously treated with antivitamin K drugs. The mean plasma DCP level in the healthy subjects was 3.02 VGH u/l (0 to 6 VGH u/l), while the mean DCP level in the patients treated with antivitamin K drugs was 214.2 VGH u/l (73-323 VGH u/l). 62% of the patients with PHC had DCP levels over 10 VGH u/l which we regarded as abnormal. On the other hand, none of the patients having benign liver disease (cirrhosis of liver or hepatitis) had abnormal DCP. In the patients with metastatic carcinoma of liver, 36.36% had abnormal DCP level. From these data, we found that none of the subjects having benign liver diseases had high DCP level. Thus, though we can not rule out the possibility of PHC in a patient with normal DCP, we should always suspect a patient of benign liver disease but with high DCP to be probable PHC. This is an important characteristic of DCP on the diagnostic value of PHC.

並列關鍵字

Des-gamma-carboxyprothrombin ； Primary hepatocellular carcinoma ； Liver diseases

國際替代計量

去羧基凝血酶原之測定及其對肝疾病之診斷意義

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