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目的 探讨肝硬变细胞核DNA含量与甲胎蛋白 (AFP)联合监测早期肝细胞癌 (HCC)发生的价值。方法 随机选择 1986年 1月至 1995年 1月我院病理诊断为肝硬变的患者 186例 ,采用图像法DNA定量技术 ,测定肝细胞核DNA含量 ,放射免疫法测定AFP水平。结果 ① 186例肝硬变患者中 ,3 7例发生HCC( 19.89% ) ,其中 2 2例已死亡 ;②随不同水平AFP、大于 5倍体值的细胞数 ( 5cER)及形状因子 (FORMPE)的递增 ,HCC发生率呈递增改变 ,且 5cER阳性率最高 ,各组间差异有显著性意义 (P <0 .0 5 ) ;③AFP与 5cER联合监测 ,HCC发生率为 72 .0 0 % ,明显高于单一AFP或 5cER监测结果 ,二者之间差异有极显著性意义 (P <0 .0 1)。结论 在肝硬变患者 ,当血清AFP或肝细胞核DNA含量持续高水平时 ,应视为HCC高危患者 ,对其应定期施行B超检查。AFP与 5cER联合监测肝硬变患者 ,可大大提高早期HCC的诊断率
Objective To investigate the value of nuclear DNA content in liver cirrhosis combined with AFP to monitor the occurrence of early hepatocellular carcinoma (HCC). Methods A total of 186 patients with pathologically diagnosed cirrhosis from January 1986 to January 1995 in our hospital were selected randomly. DNA content of hepatocytes was measured by DNA quantification. The AFP level was determined by radioimmunoassay. Results (1) Of the 186 patients with liver cirrhosis, 37 (19.89%) had HCC, of which 22 had died; (2) With different levels of AFP, cells with 5cER and FORMPE, (P <0.05) .③The combined detection of AFP and 5cER showed that the incidence of HCC was 72. 0 0%, which was significantly higher than that of 5cER Higher than single AFP or 5cER monitoring results, the difference was significant (P <0. 01). Conclusions In patients with cirrhosis, high serum levels of AFP or nuclear DNA should be regarded as high-risk patients with HCC. B-ultrasound should be performed regularly. AFP and 5cER joint monitoring of patients with cirrhosis, can greatly improve the diagnostic rate of early HCC