Clinical Evaluation of Plasma Concentrations of Protein induced by Vitamin K Absence or Antagonist-II (PIVIKA-II ), and its Altered Glycosylation in Patients with Hepatocellular Carcinoma (HCC).

学位の種類: 博士（医学）. 報告番号: 乙第1301号. 学位記番号: 新大院博（医）乙第1209号. 学位授与年月日: 平成4年4月23日新潟医学会雑誌. 1992, 106(11), 1055-1068.The plasma concentrations of PIVIKA-II in samples from 155 patients with HCC and 298 with other liver diseases were determined. The serum concentrations and fucosylation index of alpha-fetoprotein (AFP), sialyl stage-specific embryonic antigen-1 (SLX), CA-50, and Dupan-2 were also determined in 60 patients with HCC, 70 with nonneoplastic liver diseases and 25 with carcinoma metastatic to the liver. In 16 HCC patients with positive 'reactions of both PIVKA-II and AFP longitudinal series of their plasma concentrations were measured in evaluating the effect of the treatment to HCC. Next, the reactivity of PIVKA-II , AFP, prothrombin, transferrin and alpha-1-antitrypsin with concanavalin A and Lens culinaris agglutinin was studied in 11 patients with HCC by crossed jinmunoaffino-electrophoresis and affinity colomn chromatography. The results are as follow: 1. The plasma concentrations of PIVKA-II in patients with HCC were higher than those with other liver diseases with statistical significance, and the sensitivity, specificity and total accuracy of the present analysis were 54, 98 and 85%, respectively. 2. The determinations of serum concentrations and fucosylation index of AFP and SLX were also useful for diagnosing HCC, and 88% of HCC was able to be dingnosed by the measurement of these markers together with PIVKA-II serologically. 3. Simultaneous determinations of PIVKA-II and AFP were recommended in the follow-up of patients with HCC since 5 HCC patients with the dissociation of the concentrations of PIVKA-II and AFP were observed. 4. Concanavalin A-nonreactive fraction of PLVKA-II was detected in serum from patient with HCC, suggesting an altered glycosylation of PIVKA-II.博士（医学）新潟大