Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/309114
Type: TESE
Title: Avaliação da eficacia de um novo marcador tumoral, a desgamacarboxiprotrombina, no diagnostico do carcicoma hepatocelular
Author: Almeida, Jazon Romilson de Souza, 1957-
Advisor: Soares, Elza Cotrim, 1942-
Abstract: Resumo: O objetivo deste trabalho foi avaliar a contribuição de um novo marcador tumoral, a desgamacarboxiprotrombina (DCP), no diagnóstico do carcinoma hepatocelular (CHC) e compará-Io com a alfafetoproteína (AF.P.). Foram estudados 124 pacientes, sendo 92 brasileiros e 32 japoneses. Os pacientes brasileiros foram divididos em cinco grupos: 19 pacientes com carcinoma hepatocelular (grupo I), 19 com cirrose hepática (grupo II), 17 com hemangioma hepático (grupo III), 17 com metástase hepática (grupo IV) e 20 com dispepsia, sem doença hepática (grupo V). Os pacientes japoneses constituíram um outro grupo com CHC. Os exames incluídos no protocolo foram: fosfatase alcalina, gamaglutamiltransferase, aspartato aminotransferase, alanina aminotransferase, tempo de protrombina (TP), expresso em RNI (Intemational Normalized Ratio), AF.P., DCP, ultra sonografia, tomografia computadorizada, sorologia para vírus B e C e biópsia hepática. Para o diagnóstico histológico do CHC, foi utilizado o grau de diferenciação histo1ógico segundo Edmondson-Steiner. A dosagem do nível plasmático da DCP foi realizada em todos os pacientes, utilizando-se o método de enzima imuno-ensaio (ElA) (E-1023: Eitest MONO - P - II, Eisai C., Ltd., Tokyo). A positividade da DCP nos pacientes com CHC foi de 57,9%. Nos outros grupos, de 13,7%. A sensibilidade e especificidade foram de 57,9% e 86,3%, respectivamente. O valor predição positivo, de 52,4 % e negativo, de 88,7%. A concentração plasmática da DCP apresentou-se elevada nos pacientes com tumores acima de 5,0 cm e naqueles com lesões ~ltinodulares. Houve associação entre o nível plasmático de DCP e o nível sérico de A.F.P. nos pacientes com CHC (n = 49; r = 0,58998; p = 0,0001). Concluíu-se que, a DCP é um marcado r tumoral complementar para o diagnóstico do carcinoma hepatocelular e que sua combinação com a AF.P. é importante, pois aumenta a taxa de positividade do diagnóstico do CHC

Abstract: The aim of this work was to assess the usefulness of a new tumour marker, des')'-carboxy prothrombin (DCP), in the diagnosis of hepatocellular carcinoma (HCC), and to compare this with that of a-fetoprotein (AFP). The study involved 124 patients, divided into two groups (92 Brazilians and 32 Japanese). The Brazilian subject were further subdivided into tive groups: 19 patients with HCC (group I), 19 with hepatic cirrhosis (group 11), 17 with hepatic hemangioma (group 111), 17 with hepatic metastasis (group IV) and 20 with dyspepsia who were not affected by any hepatic disease (group V). The Japanese patients constituted a further HCC group. The medical and laboratory tests performed included a1kaline phosphatase (AP), ')'-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombin time, expressed by INR (International Normalized Ratio), AFP and DCP, determinations an ultrasound scan, a tomography, hepatitis B and C viruse serology and a hepatic biopsy. The histological diagnosis of HCC was based on the degree of Edmondson-Steiner histological differentiation. The plasma DCP levels were determined in ali patients using an immunoassay enzyme (ElA) (E-1023: Eitest MONO - P - 11, Eisai c., Ltd., Tokyo). Among the HCC patients, 57,9% were positive for DCP while in the other groups only 13,7% were positive.The sensitivity and specifity ofthe ElA were 57.9% and 86.3%, respectively, V{hile the predictive positive value was 52.4% and the predective negative value was 88,7%. ,A rise in the plasma concentration of DCP was observed in patients with tumours exceeding 5.0 cm in diameter and in those with multinodular lesions. There wàS a positive association between the plasma DCP ~~vels"..and the serum AFP levels in HCC patients (n = 49; r = 0.58998; p = 0.0001). We conclude that the determinations of DCP levels is a useful complementary tumour marker in the diagnosis of HCC and that the association between DCP and AFP is important because increases the frequency of positive HCC diagnose
Subject: Epidemiologia
Ultrassonografia
Cirrose hepática
Language: Português
Editor: [s.n.]
Date Issue: 1997
Appears in Collections:FCM - Tese e Dissertação

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