بررسی ارتباط بین سطح سرمی ‌مارکرهای توموری با شدت فیبروز کبد در بیماران مبتلا به هپاتیت مزمن و سیروز

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دستیار، گروه بیماری‌های داخلی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه بیماری‌های گوارش، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 متخصص قلب و عروق، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 فوق تخصص بیماری‌های گوارش، دانشکده‌ی پزشکی، دانشگاه آزاد اسلامی‌ نجف آباد، ایران

چکیده

مقدمه: مطالعات متعدد در جوامع مختلف ارتباط بین سطح سرمی بعضی مارکرهای بیوشیمیایی مانند CA125، CA15-3، a.Fetoprotein و CA19-9 را با شدت فیبروز کبدی نشان داده‌اند. مطالعه‌ی حاضر جهت بررسی این ارتباط در بیماران مبتلا به هپاتیت مزمن انجام گرفت.روش‌ها: در این مطالعه‌ی توصیفی- تحلیلی در مجموع 30 بیمار در شهرستان اصفهان بررسی شدند. ابتدا اطلاعات دموگرافیک، قد و وزن کلیه‌ی بیماران ثبت و سپس میزان پلاکت، AST، ALT، CA 19-9، CA15-3، 125CA- و آلفا فیتوپروتئین سرم آن‌ها اندازه‌گیری شد. آن گاه، بیوپسی کبد انجام و شدت فیبروز با استفاده از روش طبقه‌بندی شاخص فعالیت بافتی (Histological activity index یا HAI) تعیین شد. داده‌ها توسط آزمون‌های Multivariant logistic regression، ضریب همبستگی Spearman و Generalized linear regression تجزیه و تحلیل شد.یافته‌ها: سطح سرمی CA15-3، CA19-9 و آلفا فیتوپروتئین با شدت فیبروز کبد ارتباط معنی‌دار داشت. این ارتباط بین سطح سرمی CA125 و فیبروز کبد ‌یافت نشد (079/0 = P).نتیجه‌گیری: یافته‌های ما ارتباط بین CA15-3،  CA19-9و آلفا فیتوپروتئین را با فیبروز کبدی نشان داد. به علت حجم نمونه‌ی کم نمی‌توان استفاده از تومور مارکرهای فوق را به عنوان راهی برای تشخیص مرحله‌ی فیبروز کبدی معرفی کرد اما می‌توان بیان کرد که بالا بودن سطح سرمی تومور مارکرها به طور قطع نشانه‌ی بیماری بدخیم در این گروه بیماران نیست.

کلیدواژه‌ها

عنوان مقاله [English]

Correlation between the Level of the Tumor Markers with the Stage of Liver Fibrosis in Patients with Chronic Hepatitis and Cirrhosis

نویسندگان [English]

  • Maryam Heydarpour 1
  • Hamid Tavakkoli 2
  • Davood Shafiei 3
  • Navid Koleini 4
  • Akbar Arjmandpour 5
1 Resident, Department of Internal Medicine, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Cardiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Gastroenterologist, School of Medicine, Najafabad Branch, Islamic Azad University, Isfahan, Iran
چکیده [English]

Background: Many studies in various populations showed the correlation between the level of CA-125, CA15-3, CA19-9 and a.Fetoprotein with the stage of liver fibrosis in chronic hepatitis and cirrhosis. This study was done to evaluate this correlation in Iranian community.Methods: This cross–sectional study was performed on 30 patients with chronic hepatitis that referred for liver biopsy to the gastroenterology department of Isfahan Alzahra hospital from September 2009 to September 2010. Clinical data and routine laboratory tests at the time of liver biopsy were collected, and serum AST, ALT, CA-125, CA15-3, CA19-9 and a.Fetoprotein levels were assayed. Fibrosis staging was assigned according to the HAI (Histological activity index). Data were analyzed by multivariant logistic regression, Spearman’s Ranke Correlation Coefficient, and generalized linear model tests.Findings: Increased CA15-3, CA19-9 and a.Fetoprotein levels were correlated significantly with liver fibrosis staging (P value was 0.008 and 0.004 and 0.038 respectively). We did not find a significant correlation between serum level of CA125 and liver fibrosis staging (P = 0.079). Conclusion: Our findings suggested that elevated CA15-3, CA19-9 and a.Fetoprotein levels were associated with advanced fibrosis. Because of small sample size, we can not recommend these tumor markers as a tool for diagnosis of liver fibrosis staging. But it should be considered that elevation of mentioned markers in patients with advance cirrhosis necessarily does not mean the presence of concomitant malignant tumor.

کلیدواژه‌ها [English]

  • Alpha-fetoprotein
  • Chronic hepatitis
  • Liver fibrosis
  • CA125
  • CA19-9
  • CA15-3

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مجله دانشکده پزشکی اصفهان
دوره 29، شماره 155 - شماره پیاپی 155
مهر و آبان 1390
صفحه 1381-1388

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  • تاریخ دریافت: 24 اسفند 1389
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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