만성 간질환 및 간경변증에 동반된 간세포암 환자에서 혈청 보체치 측정의 의의

Serum complement levels were evaluated retrospectively in 68 patients with chronic liver diseases: 21 patients with chronic active hepatitis, 25 patients with liver cirrhosis, and 22 patients with hepatocellular carcinoma in liver cirrhosis. There was no significant difference in serum complement levels between the chronic active hepatitis patients and the control group. Serum complement levels were significantly reduced in the liver cirrhosis group compared with the chronic active hepatitis and normal control groups, while hepatocellular carcinoma in the liver cirrhosis group showed significantly high serum complement levels compared with the liver cirrhosis only group. Serum C3 levels correlated well with the serum albumin levels and prolonged prothrombin times in chronic active hepatitis and liver cirrhosis patients but not in the hepatocellular carcinoma patient group. The cutoff values of the complements for detection of hepatocellular carcinoma in patients with liver cirrhosis were set according to a retrospective study. Based on these data, a prospective study was performed to detect hepatocellular carcinoma in 58 patients with liver cirrhosis. The positive predictive values, negative predictive values, and accuracies of the complements were as follows: 83.3%, 79.4%, and 81.0% for C3, 87%, 80.0%, and 82.8% for C4 respectively. Thus, these data suggest that measuring serum complement levels may be helpful in the follow-up evaluation of patients with chronic liver diseases, and the combination of complements tests and α-fetoprotein test could be useful in the early detection of hepatocellular carcinoma in liver cirrhosis patients.