| Obj ecdtive (1) To investigate the expression of CYK 18 in HCC and the relation- ship between the levels of serum TPS and the proliferating activities of HCC cells. (2) To assess the value of serum TPS in the diagnosis of early subclinic and subclinic HCC,in early predicting relapse and metastasis of HCC,in monitoring and prognosis. Methods (1) The expression of CYK 18 and PCNA were studied with immuno- histochemical staining SABC in paraffin embedded preparations. (2) The levels of serum TPS and AFP were determined with ELISA and enzyme immunoassay semi-automaticly. (3) The clinical vales of serum TPS were assessed by selecting proper patients who were suffered from HCC,cirrhosis and hepatitis,respectively. Results (1) All of the HCC sections are positively stained by CYK 18 and PCNA with IHC-SABC. (2) The PCNA stainings include: + 62.5% (60/96),++ 26.0% (25/96); +-f-+ 8.3%(8/96),++++ 3.1%(3/96);The median TPS levels of the four groups are + 137.98 u/l,++ 685.3 u/1,+++ 1126 u/l and ++++ 4672 u/l,respectively. There are significant differences among the four groups(P<0.001, K-W test). (3) Controlled to the normal healthy group,the diagnostic Se of TPS and AFP is 89.6% and 73.0% respectively. There is significant difference between them(P<0.01,U test).While in small HCC,the diagnostic Se of TPS and AFP is 77.8% and 55.6%, respectively (P<0.05,U test). (4) The median levels of TPS in patients with hepatitis, cirrhosis,HCC are 77.5 uIl,166.91 uIl,299.06 uIl,respectively. while the median levels of AFP are 6.13 nglml,12.91 ng/ml,56.32 ng/ml,respectively.The positive rates of TPS in the three groups of hepatitis,cirrhosis,HCC are 40.0%(8/20),70.0% (21/30), 89.6%(86/96),and AFP 10.0% (2/20),26.7%(8/30), 73.0%(70/96), respectively.The false positive rates of TPS in cirrhosis and hepatitis are 70% and 40%,respectively. When combined with ultrasonography,the false positive rates decrease to 16.7% and 5%,respectively. (5) After 6 months?follow-up,22 patients who were treated by RF were divided into 3 subgroups according to the criteria of improve- ment,steadiness and advance.The serial serum levels of TPS are measured before and 1,3, 6 months after treatment.The median levels(uIl) of TPS are 190.95,77.5,88.99, 125.77 in improved group(9 patients), 385.13,124.04, 147.36 200.06 in steady group(6 patients), 2632.8,232.57, 695.09, 2325.1 in advanced gr-oup(7 patients). (6) Ninety-six HCC patients who received surgical treatment were followed for one year, one patient developed distant (lung) metastasis,3 patients suffered from local recurrence.TPS show the predictive values in all of the 4 patients.The lead time vary from 3 to 6 months.While AFP show the values just in 2 of 4 patients,and the lead time is 3 months. (7) Ninety-six HCC patients who received surgical treatment and 22 patients who were treated by RF were followed for one year.The one-year survival rate is 91.5% in surgical group,and 45.5% in RF group.The pretreatm-ent levels of TPS in survival and died groups are 246.84 ull(78.3- 1870) and 4400.9 uIl(l25 7.7-5260.3) in surgical group, 186.12 u/l(31.02- 2650) and 288 5.3 uIi(993.16-4587.8) in RF group.There are significant differences between the survival and died grou...
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