원발성 간암에서 혈청동 및 혈장 Fibrinogen 의 진단 및 예후판정의 의의 = Diagnostic and Prognostic Value of Serum Copper and Plasma Fibrinogen in Hepatocellular Carcinoma원발성 간암에서 혈청동 및 혈장 Fibrinogen 의 진단 및 예후판정의 의의

다국어 초록 (Multilingual Abstract)

An increased serum copper (Scu) level has been observed in some solid tumor as lymphomas and also in hepatocellular carcinoma, and some studies suggested the usefulness of determination of Scu level in the differential diagnosis between hepatoma and cirrhosis. But there were no studies about the Scu changes after transhepatic arterial embolization (TAE), relationship between Scu and hepatoma size and portal vein thrombosis, and relationship between Scu and a-fetoprotein. To investigate the diagnostic and prognostic value of plasma fibrinogen (PF) as acute phase reactant and Scu in primary hepatocellular carcinomas, We studied 50 cases of hepatoma, 30 cases of liver cirrhosis and 30 cases of normal control. The results are follows: 1) In hepatomas, Scu level was 197.04±70.35 ug/dl (Mean+ SD) (92.0±59.06 ug/dl in cirrhosis: p < 0.0001, 92.15±20.92 ug/dl in normal controls: p<0.0001). 2) In hepatomas, PF level was 387.40±115.34 mg/dl (Mean+ SD) (266.89±59.06 mg/dl in cirrhosis; P < 0.0001, 282.03±74.03 mg/dl in normal control; P < 0.0001). 3) Scu had a relatively good sensitivity (0.64) and a very high specificity (1.00) at a cutoff value of 160 ug/dl. The combination of Scu and PF improved the diagnostic value slightly. 4) In 11 patients Scu levels decreased 2 Months after TAE from 193.81±44.54 ug/dl (Mean±SD) to 11.49± 39 52 ug/dl(p < 0.0001). 5) The Scu level of diffuse infiltrative hepatoma associated with portal vein thrombosis and larger sized hepatoma were more elevated than the one of localized hepatoma without portal vein thrombosis and smaller sized hepatomas, but there was no statistical significance. 6) There was no relationship between Scu level and α-fetoprotein level. 7) There was no relationship between Scu level and total bilirubin, SGOT/SGPT and alkaline phosphatase. In conclusion, these findings suggested that Scu level may be used as a screening test for early detection of neoplastic degeneration from cirrhosis. And it is corelated with the extension of tumor mass and simultaneous check of PF level with Scu level may provide the more diagnostic and prognostic value in hepatoma.