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High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis

世界胃肠病学杂志：英文版 2008年第10期14卷 1549-1552页

作者： Aldo Spadaro Vincenza Tortorella Carmela Morace Agostino Fortiguerra Paola Composto Caterina Bonfiglio Angela Alibrandi Carmelo Luigiano Giuseppe De Caro Antonino Ajello Oscar Ferraù Maria Antonietta Freni Department of Medicine and Pharmacology University Hospital Messina 98125 Italy Department of Statistics University oMessina Messina 98125 Italy

AIM: To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration. METHODS: Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD ± 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution. RESULTS: Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17. CONCLUSION: In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.

关键词：肝细胞癌肝硬化腹水 D-二聚物

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Low utility of plasma Nociceptin/orphanin FQ in the diagnosis of hepatocellular carcinoma

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World Journal of Gastroenterology 2006年第29期12卷 4716-4720页

作者： Aldo Spadaro Antonino Ajello Carmelo Luigiano Carmela Morace Maria Letizia Resta Grazia Berlinghieri Salvatore Campo Claudio Scisca Angela Alibrandi Graziella D'arrigo Nunziata Alessi Oscar Ferraù Maria Antonietta Freni Dipartimento Clinico Sperimentale di Medicina e Farmacologia Clinica Medica Pad.CAOUVia Consolare Valeria No.1Messina 98125Italy

瞄准：在肝细胞癌(HCC ) 的察觉的浆液 alpha-fetoprotein (alpha-FP ) 的用途是可疑的。nociceptin/orphanin FQ (N/OFQ ) 的很高的传播层次，为新奇 opioid 受体的 ligand，最近在 HCC 被报导了。这研究的目的是在与肝肝硬化在病人产... 详细信息

瞄准：在肝细胞癌(HCC ) 的察觉的浆液 alpha-fetoprotein (alpha-FP ) 的用途是可疑的。nociceptin/orphanin FQ (N/OFQ ) 的很高的传播层次，为新奇 opioid 受体的 ligand，最近在 HCC 被报导了。这研究的目的是在与肝肝硬化在病人产生的 HCC 的诊断估计血浆 N/OFQ 的角色。方法：血浆 N/OFQ 层次被 ELISA 在 58 个病人(28 HCC 和 30 肝肝硬化) 并且在 25 健康控制测量。价值被相关与临床并且实验室特征包括 alpha-FP。枪兵索引，寒风伊朗的银币相关系数，非参量的联合(NPC ) 测试和判别式逐步的分析被用于数据的统计评估。结果：nociceptin 的上面的正常限度是 122 pg/mL。在这上面的血浆层次截止与 HCC 在 21.4% 病人被发现，在 23.3% 那些与肝硬化并且在 8% 健康题目。200 ng/mL 与肝硬化那些与 HCC 并且在没有在 46.4% 病人被发现的 alpha-FP 浆液层次 > 。没有关联在 N/OFQ 层次和任何东西之间被发现临床并且实验室特征，包括 alpha-FP。由 NPC 测试， HCC 和肝脏硬化症的病人关于 alpha-FP 是不同的(P = 0.000 ) 然而并非以 nociceptin (P = 0.595 ) 。由点寒风伊朗的银币关联， HCC 存在断然与 alpha-FP 被相关(rpb = 0.52， P = 0.000 ) 然而并非与 N/OFQ (rpb = 0.16， P = 0.157 ) 。在判别式分析， alpha-FP 在 Wilks 测试是重要的(Y =-0.709 + 0.03 alpha-FP ) 并且适当地分类 81% 所有病人和 61% HCC。N/OFQ 比 alpha-FP 有更低的敏感，特性和预兆的价值。结论：Nociceptin 与长期的肝疾病在病人被增加，独立于 HCC 的存在，尽管内在的机制还得被澄清。我们断定它不是为 HCC 的一个有用标记。

关键词：等离子体诊断方法肝细胞癌病理机制

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Serum chromogranin-A in hepatocellular carcinoma: Diagnostic utility and limits

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World Journal of Gastroenterology 2005年第13期11卷 1987-1990页

作者： Aldo Spadaro Antonino Ajello Carmela Morace Agata Zirilli Graziella D'arrigo Carmelo Luigiano Francesco Martino Anna Bene Domenico Migliorato Santi Turiano Oscar Ferraù Maria Antonietta Freni Dipartimento Clinico Sperimentale di Medicina e Farmacologia Dipartimento di Statistica Dipartimento di Scienze Radiologiche Unità Operativa di Gastroenterologia

AIM: The utility of serum alpha-fetoprotein (α-FP) for the detection of hepatocellular carcinoma (HCC) is questionable.High serum levels of chromogranin-A (CgA) have recently been reported in HCC. Impaired hepatic, renal, and heart functions influence circulating CgA. The aim of this study was to assess sensitivity and specificity of serum CgA as a marker of HCC in patients with liver cirrhosis (LC).METHODS: Serum CgA levels were measured by RIA in 339 patients of which 54 HCC, 132 LC, 45 chronic hepatitis (CH), 27 chronic heart failure (CHF), 36 chronic renal failure (CRF), 45 chronic inflammatory bowel disease (IBD)as disease controls and in 75 healthy controls. Patients with liver disease or IBD and concomitant renal and/or heart failure were excluded. Pearson correlation, nonparametric combination test and confidence interval analysis were used for statistical analysis.RESULTS: Serum CgA above normal values (100 ng/mL)were found in 83% of HCC patients, in 48% of LC patients,in 20% of CH patients, in 33% of IBD patients, in 92% of CRF patients, in 100% of CHF patients, and in none of the healthy controls. The mean CgA values in HCC (769±1 046), in LC (249±369), in CH (87±94), in CRF (1 390±1 401), in CHF (577±539), in IBD (146±287) were significantly higher than those in healthy controls (48±18).HCC patients had higher CgA values (P＜0.01) than LC,CH, and IBD patients but did not differ from those with CRF or CHF. The 95% CI for the mean (250-1 289 ng/mL)in HCC patients was selected as a CgA range and the lower value of such range was assumed as cut-off.Sensitivity and specificity of CgA, calculated in relation to the cut-off in patients with cirrhosis and HCC, were respectively 61% (CI 48-73%) and 82% (CI 75-88%).Serum α-FP values were ＞200 ng/mL in 21% of the HCC patients and in none of the LC patients. No significant correlation was found between α-FP and CgA in patients with HCC and in patients with cirrhosis.CONCLUSION: When HCC is suspected and α-FP is normal or ＜200 ng/mL, CgA serum values represent a co

关键词：嗜铬粒蛋白-A 血清肝细胞癌诊断方法

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