摘要
目的 探讨测定血清CRP能否用于鉴别肝细胞癌 (HCC)与肝硬化。方法 测定 10 4例并发HCC的肝硬化患者血清CRP和AFP ,以 5 4例单纯肝硬化患者作为对照组。结果 4 7.1%的HCC患者和 38.9%对照组血清CRP升高(>6mg/L) ,块状型或弥漫型HCC中血清CRP水平及高值CRP所占比例明显高于小癌型和结节型HCC及对照组 (P<0 .0 5 )。对照组中CRP水平和Child Pugh分级没有明显的相关性。用CRP和AFP至少 1项升高为判别标准 ,块状型或弥漫型HCC与对照组有明显差别 ,但是特异性和准确性较低 (分别为 5 6 %和 <70 % )。以 12mg/L作为CRP临界值可以区分弥漫型HCC与对照组 ,灵敏度、特异性和准确性分别为 76 .9%、85 .2 %和 83.6 % (P <0 .0 1)。结论 血清CRP不能作为肝癌的标志 ,但是肝硬化患者CRP水平很高时可提示存在弥漫型肝癌。
Objective To detemine whether CRP measurement could be used to identify patients with hepatocellular carcinoma(HCC) among those with cirrhosis.Methods Serum levels of CRP and AFP were measured in 104 patients with cirrhosis and HCC.Another 54 patients with cirrhosis alone used as controls.Results Overall,serum CRP levels were elevated (>6 mg/L) in 47.1% of patients with cirrhosis and HCC and 38.9% of controls,the levels and incidence of elevated CRP in patients with massive or diffuse type HCC were significantly higher than those in patients with small or nodular type HCC and controls(P<0.05).There was no significant correlation between CRP levels and Child Pugh's classification in controls.Using elevated CRP and/or AFP(>20 μg/L)as criterion showed a significant difference between patients with massive or diffuse type HCC and controls,but the specificity(56%)and accuracy(<70%)were low.Value of 12 mg/L could be used as CRP cut?off value to distinguish diffuse type HCC from controls (sensitivity 76.9%,specificity 85.2%,accuracy 83.6%,P<0.01).Conclusion Serum CRP can not be used as a marker for HCC,but very high levels of CRP in patients with cirrhosis may suggest the presence of diffuse type HCC.
出处
《中国实验诊断学》
2002年第3期136-138,共3页
Chinese Journal of Laboratory Diagnosis
