Klinický význam mírně zvýšených hodnot α−fetoproteinu v séru u pacientů s chronickou hepatitidou C a B

Česká verzia

Authors: J. Stránský ¹; H. Kopřivová ²; M. Hořejšová ³; J. Stříteský ⁴
Authors place of work: I. interní klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Jiří Horák, CSc. ¹; Ústav biochemie a patobiochemie 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta doc. MUDr. Petr Čechák, CSc. ²; II. interní klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Michal Anděl, CSc. ³; Ústav patologie 1. lékařské fakulty UK a VFN, Praha, přednosta prof. MUDr. Cyril Povýšil, DrSc. ⁴
Published in the journal: Vnitř Lék 2005; 51(4): 409-413
Category: Original Contributions

Summary

Alfa-fetoprotein (AFP) is a fetal serum glykoprotein, which is mostly found in hepatocelular carcinoma but its moderate elevated level was evidenced also in acute and chronic viral hepatitis. The authors evaluated the clinical importance of alfa-fetoprotein moderate elevated levels in serum of 125 adults with chronic hepatitis B (N = 40) and C (N = 85). Morphological finding in the liver was verified by liver biopsy in 75%.

Results:
An average score of histological activity index in anti-HCV positive individuals with cirrhosis was higher than in chronic hepatitis (p < 0.05), and correlated with AFP concentration and AST activity in serum (both p < 0.01). The average AFP concentration in serum in patients with chronic hepatitis was lower than in patients with cirrhosis (p < 0.05) and more correlated with AST activity (p < 0.01) than ALT (p < 0.05) and low number of thrombocytes (p < 0.01). There were not found out any statistical differences between patients with chronic hepatitis and cirrhosis and levels of AFP in the chronic hepatitis B patients which were mostly normal.

Conclusion:
The results suggest that the moderate elevation of AFP levels in serum in patients with chronic hepatitis C is probably the sign of chronic hepatitis change to cirrhosis.Therefore it is important to recommend antiviral treatment to these patients if they are not drug users or alcoholics. Monitoring of AFP levels is more useful in chronic hepatitis C than B.

Key words:
alfa-fetoprotein – chronic hepatitis C – chronic hepatitis B

Zdroje

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