【摘要】 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的诊断率更多还原

【Abstract】 Objective The usefulness of measurement of nuclear DNA content elevation for diagnosis of early hepatocellular carcinoma was evaluated by a study of 186 patients with liver cirrhosis. Methods Nuclear DNA content was measured using an automatic image analysis system. Results ①Hepatocellular carcinoma was found in 37 patients during 10 years follow up, the cumulative incidence of hepatocellular carcinoma was 19.89%. ②The incidence of hepatocellular carcinoma increased with the increase of the patterns of α fetoprotein (AFP), 5c exceeding rate (5cER), FORM PE, but positive predictive value of 5cER was the highest of three parameters, the difference among all groups was significant by the χ 2 test ( P < 0.05). ③When 5cER joined AFP for monitoring development of hepatocellular carcinoma, the incidence of hepatocellular carcinoma was 72.00%, which was significantly higher than that of 5cER or AFP alone, the difference between groups was highly significant ( P <0.01).Conclusion Patients who had 5cER levels of 3%-5% or more, who had transient increases in 5cER or who had both, should be treated as being in a super high risk group for hepatocellular carcinoma. Frequent and careful examination by ultrasonography of such patients is recommended. It is important that measurement of 5cER join with AFP in cirrhotic patients monitored for early development of hepatocellular carcinoma.更多还原