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간암 환자에서 혈청 인터루킨 - 6 측정의 임상적 유용성
홍요한(Yo Han Hong),박중원(Joong Won Park),차영주(Young Joo Cha),김미경(Mi Kyung Kim),김형준(Hyung Joon Kim),도재혁(Jae Hyuk Do),김재규(Jae Gyu Kim),유병철(Byung Chul Yoo),박실무(Sill Moo Park) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5
Background/Aims: Interleukin-6 (IL-6) has been reported as a mediator of growth control in several human neoplasms, including cholangiocellular carcinomas (CCC). The clinical utility of the serum IL- 6 was evaluated for patients with primary and metastatic liver cancer regarding to differential diagnosis of liver cancers. Methods: Clinical characteristics and serum level of IL-6 were examined in 50 patients [ 13, CCC; 21, hepatocellular carcinomas (HCC) ; 16, metastatic adenocarcinomas (MAC) ] , using an enzyme linked immunosorbent assay (ELISA) and immunohistochemistry specific for IL-6. Results: Hyperbilirubinemia was observed more frequently in the patients than in the patients with HCC or MAC. The elevation of serum IL-6 level was detected in all the CCC patients, 13 HCC patients, and 8 MAC patients. However, 6 healthy controls did not show it. Mean level of serum IL-6 was significantly higher in the patients with CCC ( 263.8 pg/mL) than in the patients with HCC ( 21.8 pg/mL) and MAC ( 6.8 pg/mL) ( p=0.0185). Serum level of IL-6 was correlated with tumor burden in the patients with CCC (r= 0.57, p=0.042). IL-6 expression was more frequently observed in CCC and HCC specimens than in MAC specimens by immunohistochemical study (p= 0.0136). Conclusions: A high serum level of IL-6 marks CCC patients and correlates with tumor burden. The immunohistochemical study of IL-6 may distinguish CCC from MAC. ( Korean J Gastroenterol 2002; 39: 362-369)
비알코올성 지방간 환자에서 지방간염의 병리학적 심화도를 예측할 수 있는 임상적 지표들
유병철,김상진,박중원,김미경,김재규,박실무,김형준,홍요한,한성혁 대한소화기학회 2000 대한소화기학회지 Vol.36 No.6
Background/Aims: Nonalcoholic steatohepatitis (NASH) may progress to advanced liver disease. The aims of our study were to examine clinical factors distinguishing NASH from simple steatosis in patients with nonalcoholic fatty liver and to identify clinical predictors reflecting the pathologic severity in patients with NASH. Methods: For thirty-nine patients with fatty liver, medical history, body mass index (BMI), and the results of serological test and ultrasonography of liver, were reviewed retrospectively. Then, the clinical and biochemical data of nonalcoholic steatosis (NAS) and NASH was compared. Results: NAS was observed in fifteen patients (median age: 32.7, M:F=13:2) and NASH was observed in twenty-four patients (median age: 32.8, M:F=17:7). Only body mass index (BMI) showed the significant difference between NASH (28.4±3.4) and NAS (25.8±2.8) (p$lt;0.03). The incidence of NASH was high in patients with BMI over 28.9. Serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio was reveely correlated with the degree of steatosis (p$lt;0.01). Multivariate analysis showed the correlation between BMI and the degree of fibrosis (p$lt;0.01) and the reverse-relation between serum ALT value and the degree of fibrosis (p$lt;0.01). Coclusions: BMI helps identify NASH in patients with nonalcoholic fatty liver. In patients with NASH, high BMI accompanied with low ALT value and severe fatty change on ultrasonography could suggest severe fibrosis. Thus, these patients need a close follow-up including a liver biopsy.