원발성 간암에 있어서 혈청 Alphafetoprotein 의 진단적 의의에 관하여 = The Diagnostic Significance of the Serum Alphafetoprotein in Pirmary Hepatocellular Carcinoma원발성 간암에 있어서 혈청 Alphafetoprotein 의 진단적 의의에 관하여

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

An elevated serum alphafetoprotein (AFP) concentration in a nonpregnant adult is the most discriminating laboratory test indicative of malignant disease now available. AFP is found on low concentration in the serum of normal adults, but it appears in high concentration in fetal serum at 12 weeks gestation. Elevations in adults are associated with pregnancy, a variety of nonneoplastic liver diseases, primary hepatocellular carcinoma and teratocarcinoma containing yolk sac elements. Extensive evaluation of the serum AFP concentration as a diagnostic marker for primary hepatocellular carcinoma has been carried out over the last 10 years. The measurement of serum AFP concentration is very useful in the diagnosis of hepatocellular carcinoma. Hepatitis B virus has been linked to hepatocarcinogenesis and recent evidence suggests incorporation of the hepatitis B virus genome into the cancer cell chromosome. Serum AFP was measured quantitatively by radioimmunoassay technique in 296 patients, who visited the out-clinic or were hospitalized at Chonnam University Hospital during the period from June 1981 to July 1983. Those who were tested included 33 cases of normal population as control group, 133, hepatic diseases(46, primary hepatocelluar carcinoma; 11, hepatic metastatic tumor; 76, cirrhosis of liver; 13, acute viral hepatitis; 24, chronic hepatitis), 70 cases of nonhepatic malignant diseases, and 23 cases of the other nonhepatic diseases as the disease group. HBsAg was measured by enzyme immunoassay technique in 35 out of 46 cases of primary hepatocellular carcinoma. The results obtained were as follows; 1) The serum AFP concentration in 33 cases of normal control subjects was 4+-3 ng/ml (Mean+-S.D., Range: 0-12 ng/ml). Upper limit of serum AFP concentration in the normal adult was considered 10 ng/ml, which was derived from mean+-1.96 S.D. 2) In hepatic diseases, the serum AFP concentration was 30+-67 ng/ml(2-248 ng/ml) in acute viral hepatitis, 34+-57 ng/ml(1-260 ng/ml) in chronic active hepatitis, 10+-17 ng/ml (1-35 ng/ml) in chronic persistent hepatitis, 46+-74 ng/ml(0-350 ng/ml) in cirrhosis, 1,590+-2,245 ng/ml(0-8,000 ng/ml) in primary hepatocellular carcinoma and 86+-132 ng/ml(0-360ng/ml) in metastatic tumor of the liver. 3) Serum AFP concentration was exceeded the 400ng/ml only in hepatocellular carcinoma, which was revealed in 26 cases out of 46 cases of primary hepatocellular carcinoma. 4) HBsAg was positive in 21 cases out of 35 cases of primary hepatocellular carcinoma. In 16 out of 21 HBsAg positive cases, AFP was exceeded 400 ng/ml. 5) There were no significant changes of serum AFP concentration in the process of disease. Follow-up examination had been done at 2 to 6 weeks later the initial examination.