AIM:To investigate the biological role of alpha fetoprotein (AFP) and its clinical signif icance in carcinogenesis of hepatocellular carcinoma (HCC).METHODS:Clinical analysis of HCC patients and im-munohistochemical e...AIM:To investigate the biological role of alpha fetoprotein (AFP) and its clinical signif icance in carcinogenesis of hepatocellular carcinoma (HCC).METHODS:Clinical analysis of HCC patients and im-munohistochemical examination were conducted to evaluate the relationship between serum AFP level and patient mortality. Confocal microscopy,Western blotting, dimethylthiahzolyl-2,5-diphenyl-tetrazolium bromide,Cell Counting Kit-8 assays and flow cytometry were performed to explore the possible mechanism.RESULTS: Among the 160 HCC patients enrolled in this study,130 patients survived 2 years (81.25%),with a survival rate of 86.8% in AFP < 2 0 μg/L group,88.9% in AFP 20-250 μg/L group,and 69.6% in AFP > 250 μg/L group, demonstrating a higher mortality rate in HCC patients with higher AFP levels. Surgical treatment was benef icial only in patients with low AFP levels.The mortality rate of HCC patients with high AFP levels who were treated surgically was apparently higher than those treated with conservative management.The results of immunohistochemistry showed that AFP and AFP receptor were merely expressed in tissues of HCC patients with positive serum AFP.Consistently,in vitro analysis showed that AFP and AFPS were expressed in HepG2 but not in HLE cells. AFP showed a capability to promote cell growth,and this was more apparent in HepG2 cells,in which the proliferation was increased by 3.5 folds. Cell cycle analysis showed that the percent-age of HepG2 cells in S phase after exposure to AFP was modestly increased.CONCLUSION:HCC patients with higher AFP levels show a higher mortality rate,which appears to be attributable to the growth promoting properties of AFP.展开更多
Design: Retrospective analysis. Setting: East London Hospital. Subjects: 724 women who had maternal serum alphafetoprotein levels measured between 15 to 19 weeks gestation. Main outcome measure: The main outcome measu...Design: Retrospective analysis. Setting: East London Hospital. Subjects: 724 women who had maternal serum alphafetoprotein levels measured between 15 to 19 weeks gestation. Main outcome measure: The main outcome measures were defined as any case of preeclampsia, small-for-gestational age (SGA) birth- weight th centile, placental abruption, stillbirth or early neonatal death. Methods: Women with MSAFP > 2.0 Multiples of Median (MoM) were classified as screen positive. Results: 41 (5.7%) women developed preeclampsia. Women with MSAFP > 2.0 Multiples of the Median (MoM) were significantly more likely to develop preeclampsia (p th centile展开更多
<strong>Introduction</strong><span><span><span style="font-family:;" "=""> <strong>:</strong></span></span></span><span><sp...<strong>Introduction</strong><span><span><span style="font-family:;" "=""> <strong>:</strong></span></span></span><span><span><span style="font-family:;" "="">Chronic liver disease (CLD) is a disease of public health importance. CLD is<b> </b>defined as a clinical syndrome of liver disease lasting for at least six months with histology showing varying degree of hepatocellular necro-inflammation and fibrosis with or without neoplastic transformation. The disease is a spectrum that manifests initially as chronic hepatitis which may progress to liver cirrhosis and ultimately hepatocellular carcinoma (HCC).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">The current practice in the field of Gastroenterology has shifted from invasive methods of diagnosing HCC to non-invasive methods using tumor biomarkers. Various biomarkers of HCC have been proposed, but the largest body of evidence exists with<span> alpha-fetoprotein</span> (AFP). Most of the studies on the combined diagnostic accuracy of AFP and des</span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "="">gamma</span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "="">carboxyprothrombin (DCP) were done in other populations outside Nigeria. It is necessary to determine the combined diagnostic accuracy of the two tumor markers for early detection of HCC in North-central Nigeria.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Materials and Methods</span></b></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">This study was a cross-sectional study and ethical clearance was obtained from the<b> </b>ethical and research committee of UITH, Ilorin. A total of 190 participants consisting of 125 cases and 65 healthy controls that were age and sex-matched were studied. Patients with extra-hepatic malignancies were excluded. The serum levels of AFP and DCP were determined using the enzyme-linked immunoassay (ELISA) technique. A detailed questionnaire was used to document the socio-demographic characteristics, clinical features as well as results of laboratory/radiologic parameters. Percutaneous liver biopsy was carried out on patients that were fit. Test of association between categorical variables was carried out using the Chi-Square Test. The sensitivity, specificity, positive and negative predictive values of the two tumor markers were determined by the area under curve (AUC) at various cut-off levels using the receiver operating characteristic (ROC) curve analysis. Statistical significance was set at p value < 0.05. AFP Quantitative test kit (alfabeto-RiakiDainabot Radioisotope laboratory, Japan) and DCP Qualitative test kit (<span>EiTest</span> MONO P-II kit) were used to assay AFP and DCP respectively. Liver biopsy needle (Menghini needle) was used to carry out liver biopsy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Results</span></b></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">Using a cut-off of 400</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">ng/ml, the sensitivity of serum AFP for diagnosing HCC was 51.3%. The specificity of AFP at the same cut-off was 87.8%. The positive and negative predictive values were 92.8% and 49.3% respectively. Using a cut-off of 7.5</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">ng/ml, the sensitivity of serum DCP for diagnosing HCC was 57.1%. The specificity of DCP at the same cut-off was 63.4%. The positive and negative predictive values were 76.2% and 41.9% respectively while the accuracy was 59.2%.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">The diagnostic accuracy of combined serum AFP and DCP for diagnosis of HCC in University of Ilorin Teaching Hospital, Ilorin was 64.9%. The sensitivity of combined serum AFP and DCP for diagnosing HCC was 55.6%. The specificity of combined serum AFP and DCP was 95.6%. The positive and negative predictive values were 96.2% and 52.3% respectively. <b>Conclusion</b></span></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">Combining these two tumour markers does not significantly improve the diagnostic accuracy of HCC and chronic HBV remains a strong aetiological agent of HCC in UITH, Ilorin.</span></span></span>展开更多
目的探讨子宫动脉多普勒血流参数联合血清甲胎蛋白(AFP)对子痫前期及围生儿不良结局的预测价值。方法前瞻性选择2022年7月至2024年9月肇庆市第一人民医院收治的100例子痫前期患者作为观察组,根据患者病情严重程度分为轻度子痫前期组68...目的探讨子宫动脉多普勒血流参数联合血清甲胎蛋白(AFP)对子痫前期及围生儿不良结局的预测价值。方法前瞻性选择2022年7月至2024年9月肇庆市第一人民医院收治的100例子痫前期患者作为观察组,根据患者病情严重程度分为轻度子痫前期组68例和重度子痫前期组32例,并选择健康孕妇50例作为对照组,比较三组孕妇的子宫动脉血流参数阻力指数(RI)、搏动指数(PI)、收缩期/舒张期流速比值(S/D)、血清AFP水平及围生儿不良结局。采用受试者工作特征(ROC)曲线评价子宫动脉多普勒血流参数联合血清AFP对子痫前期及围生儿不良结局的预测价值。结果重度子痫前期组孕妇的RI、PI、S/D水平分别为0.71±0.15、1.36±0.23、3.47±0.41,明显高于轻度子痫前期组的0.63±0.10、1.15±0.17、2.57±0.34,和对照组的0.55±0.06、0.84±0.12、2.30±0.25,血清AFP水平为(34.36±3.92)μg/L,明显低于轻度子痫前期组的(45.21±4.70)μg/L和对照组的(49.20±6.85)μg/L,且轻度子痫前期组孕妇的血清RI、PI、S/D水平明显高于对照组,血清AFP水平明显低于对照组,差异均有统计学意义(P<0.05);重度子痫前期组孕妇的分娩孕周、胎盘重量、新生儿体质量及1 min Apgar评分分别为(33.74±2.95)周、(589.92±40.25)g、(2520.18±380.47)g、(7.40±0.53)分,明显高于轻度子痫前期组的(37.13±3.20)周、(630.15±50.12)g、(2750.25±395.24)g、(7.88±0.67)分和对照组的(40.22±2.03)周、(690.95±66.53)g、(3210.84±400.58)g、(8.91±0.73)分,且轻度子痫前期组孕妇的分娩孕周、胎盘重量、新生儿体质量及1 min Apgar评分明显高于对照组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,RI、PI、S/D、AFP的曲线下面积(AUC)为0.801、0.792、0.788、0.687,敏感度分别为85.74%、84.15%、82.63%、87.50%,特异性分别为75.33%、72.15%、71.88%、87.00%,子宫动脉多普勒血流参数联合血清AFP的AUC、敏感度、特异性分别为0.885、91.27%、90.55%,提示子宫动脉多普勒血流参数联合血清AFP检测对子痫前期及围生儿不良结局具有较高的预测价值。结论子宫动脉多普勒血流参数联合血清AFP对子痫前期及围生儿不良结局的预测价值较高,值得临床推广应用。展开更多
基金Supported by The National Natural Science Foundation of China,No.30671856,30772536 and 81072710Beijing Natural Science Foundation,No.7101006+2 种基金the state key project for infectious diseases,2008ZX10002-015,2008ZX10002-005-3Beijing Science and Technology Commission,Z111107058811067High-Level Talent Academic Leader Training Program,(2011-2-09)
文摘AIM:To investigate the biological role of alpha fetoprotein (AFP) and its clinical signif icance in carcinogenesis of hepatocellular carcinoma (HCC).METHODS:Clinical analysis of HCC patients and im-munohistochemical examination were conducted to evaluate the relationship between serum AFP level and patient mortality. Confocal microscopy,Western blotting, dimethylthiahzolyl-2,5-diphenyl-tetrazolium bromide,Cell Counting Kit-8 assays and flow cytometry were performed to explore the possible mechanism.RESULTS: Among the 160 HCC patients enrolled in this study,130 patients survived 2 years (81.25%),with a survival rate of 86.8% in AFP < 2 0 μg/L group,88.9% in AFP 20-250 μg/L group,and 69.6% in AFP > 250 μg/L group, demonstrating a higher mortality rate in HCC patients with higher AFP levels. Surgical treatment was benef icial only in patients with low AFP levels.The mortality rate of HCC patients with high AFP levels who were treated surgically was apparently higher than those treated with conservative management.The results of immunohistochemistry showed that AFP and AFP receptor were merely expressed in tissues of HCC patients with positive serum AFP.Consistently,in vitro analysis showed that AFP and AFPS were expressed in HepG2 but not in HLE cells. AFP showed a capability to promote cell growth,and this was more apparent in HepG2 cells,in which the proliferation was increased by 3.5 folds. Cell cycle analysis showed that the percent-age of HepG2 cells in S phase after exposure to AFP was modestly increased.CONCLUSION:HCC patients with higher AFP levels show a higher mortality rate,which appears to be attributable to the growth promoting properties of AFP.
文摘Design: Retrospective analysis. Setting: East London Hospital. Subjects: 724 women who had maternal serum alphafetoprotein levels measured between 15 to 19 weeks gestation. Main outcome measure: The main outcome measures were defined as any case of preeclampsia, small-for-gestational age (SGA) birth- weight th centile, placental abruption, stillbirth or early neonatal death. Methods: Women with MSAFP > 2.0 Multiples of Median (MoM) were classified as screen positive. Results: 41 (5.7%) women developed preeclampsia. Women with MSAFP > 2.0 Multiples of the Median (MoM) were significantly more likely to develop preeclampsia (p th centile
文摘<strong>Introduction</strong><span><span><span style="font-family:;" "=""> <strong>:</strong></span></span></span><span><span><span style="font-family:;" "="">Chronic liver disease (CLD) is a disease of public health importance. CLD is<b> </b>defined as a clinical syndrome of liver disease lasting for at least six months with histology showing varying degree of hepatocellular necro-inflammation and fibrosis with or without neoplastic transformation. The disease is a spectrum that manifests initially as chronic hepatitis which may progress to liver cirrhosis and ultimately hepatocellular carcinoma (HCC).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">The current practice in the field of Gastroenterology has shifted from invasive methods of diagnosing HCC to non-invasive methods using tumor biomarkers. Various biomarkers of HCC have been proposed, but the largest body of evidence exists with<span> alpha-fetoprotein</span> (AFP). Most of the studies on the combined diagnostic accuracy of AFP and des</span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "="">gamma</span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "="">carboxyprothrombin (DCP) were done in other populations outside Nigeria. It is necessary to determine the combined diagnostic accuracy of the two tumor markers for early detection of HCC in North-central Nigeria.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Materials and Methods</span></b></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">This study was a cross-sectional study and ethical clearance was obtained from the<b> </b>ethical and research committee of UITH, Ilorin. A total of 190 participants consisting of 125 cases and 65 healthy controls that were age and sex-matched were studied. Patients with extra-hepatic malignancies were excluded. The serum levels of AFP and DCP were determined using the enzyme-linked immunoassay (ELISA) technique. A detailed questionnaire was used to document the socio-demographic characteristics, clinical features as well as results of laboratory/radiologic parameters. Percutaneous liver biopsy was carried out on patients that were fit. Test of association between categorical variables was carried out using the Chi-Square Test. The sensitivity, specificity, positive and negative predictive values of the two tumor markers were determined by the area under curve (AUC) at various cut-off levels using the receiver operating characteristic (ROC) curve analysis. Statistical significance was set at p value < 0.05. AFP Quantitative test kit (alfabeto-RiakiDainabot Radioisotope laboratory, Japan) and DCP Qualitative test kit (<span>EiTest</span> MONO P-II kit) were used to assay AFP and DCP respectively. Liver biopsy needle (Menghini needle) was used to carry out liver biopsy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Results</span></b></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">Using a cut-off of 400</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">ng/ml, the sensitivity of serum AFP for diagnosing HCC was 51.3%. The specificity of AFP at the same cut-off was 87.8%. The positive and negative predictive values were 92.8% and 49.3% respectively. Using a cut-off of 7.5</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">ng/ml, the sensitivity of serum DCP for diagnosing HCC was 57.1%. The specificity of DCP at the same cut-off was 63.4%. The positive and negative predictive values were 76.2% and 41.9% respectively while the accuracy was 59.2%.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">The diagnostic accuracy of combined serum AFP and DCP for diagnosis of HCC in University of Ilorin Teaching Hospital, Ilorin was 64.9%. The sensitivity of combined serum AFP and DCP for diagnosing HCC was 55.6%. The specificity of combined serum AFP and DCP was 95.6%. The positive and negative predictive values were 96.2% and 52.3% respectively. <b>Conclusion</b></span></span></span><span><span><b><span style="font-family:;" "="">: </span></b></span></span><span><span><span style="font-family:;" "="">Combining these two tumour markers does not significantly improve the diagnostic accuracy of HCC and chronic HBV remains a strong aetiological agent of HCC in UITH, Ilorin.</span></span></span>
文摘目的探讨子宫动脉多普勒血流参数联合血清甲胎蛋白(AFP)对子痫前期及围生儿不良结局的预测价值。方法前瞻性选择2022年7月至2024年9月肇庆市第一人民医院收治的100例子痫前期患者作为观察组,根据患者病情严重程度分为轻度子痫前期组68例和重度子痫前期组32例,并选择健康孕妇50例作为对照组,比较三组孕妇的子宫动脉血流参数阻力指数(RI)、搏动指数(PI)、收缩期/舒张期流速比值(S/D)、血清AFP水平及围生儿不良结局。采用受试者工作特征(ROC)曲线评价子宫动脉多普勒血流参数联合血清AFP对子痫前期及围生儿不良结局的预测价值。结果重度子痫前期组孕妇的RI、PI、S/D水平分别为0.71±0.15、1.36±0.23、3.47±0.41,明显高于轻度子痫前期组的0.63±0.10、1.15±0.17、2.57±0.34,和对照组的0.55±0.06、0.84±0.12、2.30±0.25,血清AFP水平为(34.36±3.92)μg/L,明显低于轻度子痫前期组的(45.21±4.70)μg/L和对照组的(49.20±6.85)μg/L,且轻度子痫前期组孕妇的血清RI、PI、S/D水平明显高于对照组,血清AFP水平明显低于对照组,差异均有统计学意义(P<0.05);重度子痫前期组孕妇的分娩孕周、胎盘重量、新生儿体质量及1 min Apgar评分分别为(33.74±2.95)周、(589.92±40.25)g、(2520.18±380.47)g、(7.40±0.53)分,明显高于轻度子痫前期组的(37.13±3.20)周、(630.15±50.12)g、(2750.25±395.24)g、(7.88±0.67)分和对照组的(40.22±2.03)周、(690.95±66.53)g、(3210.84±400.58)g、(8.91±0.73)分,且轻度子痫前期组孕妇的分娩孕周、胎盘重量、新生儿体质量及1 min Apgar评分明显高于对照组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,RI、PI、S/D、AFP的曲线下面积(AUC)为0.801、0.792、0.788、0.687,敏感度分别为85.74%、84.15%、82.63%、87.50%,特异性分别为75.33%、72.15%、71.88%、87.00%,子宫动脉多普勒血流参数联合血清AFP的AUC、敏感度、特异性分别为0.885、91.27%、90.55%,提示子宫动脉多普勒血流参数联合血清AFP检测对子痫前期及围生儿不良结局具有较高的预测价值。结论子宫动脉多普勒血流参数联合血清AFP对子痫前期及围生儿不良结局的预测价值较高,值得临床推广应用。
