{"id":22808,"date":"2023-04-19T16:58:01","date_gmt":"2023-04-19T09:58:01","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22808"},"modified":"2023-04-20T16:30:50","modified_gmt":"2023-04-20T09:30:50","slug":"gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/","title":{"rendered":"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan"},"content":{"rendered":"<p><strong>Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng v\u00e0 d\u1ef1 b\u00e1o tri\u1ec3n v\u1ecdng \u0111i\u1ec1u tr\u1ecb. Trong \u0111\u00f3 AFP, AFP-L3 v\u00e0 PIVKA II (DCP) l\u00e0 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n ung th\u01b0 gan.\u00a0<\/strong><\/p>\n<h2>1. D\u1ea5u \u1ea5n sinh h\u1ecdc l\u00e0 g\u00ec?<\/h2>\n<p>D\u1ea5u \u1ea5n sinh h\u1ecdc trong m\u00e1u l\u00e0 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u1ecdc \u0111\u01b0\u1ee3c \u0111o trong m\u1eabu m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n, theo d\u00f5i v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n. C\u00e1c ch\u1ec9 s\u1ed1 n\u00e0y bao g\u1ed3m:<\/p>\n<ul>\n<li>M\u00e1u \u0111\u00f4ng: M\u00e1u \u0111\u00f4ng l\u00e0 qu\u00e1 tr\u00ecnh t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ec3 ng\u0103n ch\u1eb7n m\u1ea5t m\u00e1u khi x\u1ea3y ra ch\u1ea5n th\u01b0\u01a1ng. C\u00e1c ch\u1ec9 s\u1ed1 \u0111o l\u01b0\u1eddng m\u00e1u \u0111\u00f4ng bao g\u1ed3m th\u1eddi gian \u0111\u00f4ng m\u00e1u, n\u1ed3ng \u0111\u1ed9 fibrinogen v\u00e0 prothrombin time.<\/li>\n<li>\u0110\u01b0\u1eddng huy\u1ebft: \u0110\u01b0\u1eddng huy\u1ebft \u0111o l\u01b0\u1eddng n\u1ed3ng \u0111\u1ed9 \u0111\u01b0\u1eddng trong m\u00e1u v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng.<\/li>\n<li>Ch\u1ec9 s\u1ed1 gan: C\u00e1c ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng gan nh\u01b0 AST (aspartate aminotransferase), ALT (alanine aminotransferase), bilirubin v\u00e0 albumin th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o \u0111\u1ec3 ki\u1ec3m tra ch\u1ee9c n\u0103ng gan.<\/li>\n<li>Ch\u1ec9 s\u1ed1 th\u1eadn: C\u00e1c ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng th\u1eadn nh\u01b0 creatinine v\u00e0 blood urea nitrogen (BUN) th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o \u0111\u1ec3 ki\u1ec3m tra ch\u1ee9c n\u0103ng th\u1eadn.<\/li>\n<li>C\u00e1c ch\u1ec9 s\u1ed1 kh\u00e1c: C\u00e1c ch\u1ec9 s\u1ed1 kh\u00e1c nh\u01b0 n\u1ed3ng \u0111\u1ed9 protein, enzyme, ch\u1ea5t b\u00e9o, axit nucleic c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111o \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c trong c\u01a1 th\u1ec3.<\/li>\n<\/ul>\n<p>Vi\u1ec7c \u0111\u00e1nh gi\u00e1 c\u00e1c d\u1ea5u hi\u1ec7u sinh h\u1ecdc trong m\u00e1u l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p quan tr\u1ecdng trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<h2>2. C\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan<\/h2>\n<h3>2.1. Ch\u1ec9 s\u1ed1 AFP<\/h3>\n<figure id=\"attachment_24829\" aria-describedby=\"caption-attachment-24829\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-24829 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1163190975-612x612-1-300x200.jpg\" alt=\"AFP l\u00e0 m\u1ed9t d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1163190975-612x612-1-300x200.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1163190975-612x612-1.jpg 612w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-24829\" class=\"wp-caption-text\">AFP l\u00e0 m\u1ed9t d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan<\/figcaption><\/figure>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/xet-nghiem-afp-la-gi-va-co-y-nghia-nhu-the-nao\/\">AFP<\/a> l\u00e0 vi\u1ebft t\u1eaft c\u1ee7a Alpha-fetoprotein, l\u00e0 m\u1ed9t protein \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o gan c\u1ee7a thai nhi trong b\u1ee5ng m\u1eb9 v\u00e0 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi l\u1edbn, bao g\u1ed3m c\u1ea3 nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh ung th\u01b0 gan. Ch\u1ec9 s\u1ed1 AFP \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ch\u1ec9 s\u1ed1 sinh l\u00fd \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng gan. Khi t\u1ebf b\u00e0o gan b\u00ecnh th\u01b0\u1eddng b\u1ecb t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c bi\u1ebfn \u0111\u1ed5i, n\u00f3 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng s\u1ea3n xu\u1ea5t AFP. Do \u0111\u00f3, ch\u1ec9 s\u1ed1 AFP c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 gan v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>Ch\u1ec9 s\u1ed1 AFP th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng m\u00e1y \u0111o huy\u1ebft thanh v\u00e0 k\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o d\u01b0\u1edbi d\u1ea1ng ng\/mL. <b>M\u1ee9c b\u00ecnh th\u01b0\u1eddng c\u1ee7a n\u1ed3ng \u0111\u1ed9 AFP v\u1edbi ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh l\u00e0 t\u1eeb 0 &#8211; 8 ng\/ml<\/b>.. Tuy nhi\u00ean, m\u1ee9c \u0111\u1ed9 n\u00e0y c\u00f3 th\u1ec3 kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o tu\u1ed5i t\u00e1c, gi\u1edbi t\u00ednh v\u00e0 tr\u1ea1ng th\u00e1i s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi \u0111\u00f3. M\u1ee9c r\u1ea5t cao: 500 &#8211; 1000 ng\/ml tr\u1edf l\u00ean, th\u01b0\u1eddng l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a c\u00e1c b\u1ec7nh ung th\u01b0. N\u1ed3ng \u0111\u1ed9 AFP tr\u00ean 200 ng\/ml th\u00ec c\u00f3 th\u1ec3 b\u1ecb ung th\u01b0 gan. N\u1ebfu d\u01b0\u1edbi 200 ng\/ml s\u1ebd l\u00e0m th\u00eam ch\u1ec9 s\u1ed1 AFP-L3.<\/p>\n<p>Tuy nhi\u00ean, ch\u1ec9 s\u1ed1 AFP kh\u00f4ng ph\u1ea3i l\u00e0 ch\u1ec9 s\u1ed1 \u0111\u1ed9c l\u1eadp \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan v\u00e0 kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan \u0111\u1ec1u c\u00f3 m\u1ee9c \u0111\u1ed9 AFP t\u0103ng. Ch\u1ec9 s\u1ed1 AFP th\u01b0\u1eddng t\u0103ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan m\u1ea1n t\u00ednh, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 t\u0103ng trong nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nh\u01b0 vi\u00eam gan v\u00e0 x\u01a1 gan do r\u01b0\u1ee3u.<\/p>\n<p>Ngo\u00e0i ch\u1ec9 s\u1ed1 AFP, c\u00e1c b\u00e1c s\u0129 c\u0169ng s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, bao g\u1ed3m si\u00eau \u00e2m, CT, MRI v\u00e0 x\u00e9t nghi\u1ec7m sinh thi\u1ebft gan.<\/p>\n<h3>2.2. Ch\u1ec9 s\u1ed1 AFP-L3<\/h3>\n<p>AFP-L3 l\u00e0 m\u1ed9t d\u1ea1ng \u0111\u1eb7c bi\u1ec7t c\u1ee7a protein AFP (Alpha-fetoprotein), \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o ung th\u01b0 gan. AFP-L3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ch\u1ec9 s\u1ed1 ch\u1ea9n \u0111o\u00e1n ph\u1ee5 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ung th\u01b0 gan v\u00e0 d\u1ef1 b\u00e1o t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n.<\/p>\n<p>Ch\u1ec9 s\u1ed1 AFP-L3 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng m\u00e1y \u0111o huy\u1ebft thanh v\u00e0 k\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o d\u01b0\u1edbi d\u1ea1ng ph\u1ea7n tr\u0103m (%). Ph\u1ea7n tr\u0103m n\u00e0y cho bi\u1ebft t\u1ef7 l\u1ec7 AFP-L3 trong t\u1ed5ng s\u1ed1 AFP c\u00f3 trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n. V\u1edbi ch\u1ea5t AFP-L3, khi m\u1ee9c \u0111\u1ed9 t\u1ed3n t\u1ea1i trong huy\u1ebft thanh <strong>th\u1ea5p h\u01a1n 10%<\/strong> l\u00e0 b\u00ecnh th\u01b0\u1eddng.\u00a0<b>Gi\u00e1 tr\u1ecb c\u1eaft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n d\u1ef1a tr\u00ean n\u1ed3ng \u0111\u1ed9 AFP-L3 trong huy\u1ebft thanh l\u00e0 t\u1eeb 10 ng\/ml tr\u1edf l\u00ean<\/b>. N\u1ebfu m\u1ee9c \u0111\u1ed9 t\u1ed3n t\u1ea1i t\u1eeb 10 &#8211; 15%, kh\u1ea3 n\u0103ng cao b\u1ec7nh nh\u00e2n m\u1eafc ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan v\u1edbi kh\u1ed1i u nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh d\u01b0\u1edbi 3cm.<\/p>\n<p>Ch\u1ec9 s\u1ed1 AFP-L3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ung th\u01b0 gan, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi m\u1ee9c \u0111\u1ed9 AFP t\u0103ng nh\u01b0ng k\u1ebft qu\u1ea3 si\u00eau \u00e2m v\u00e0 x\u00e9t nghi\u1ec7m m\u00e1u kh\u00e1c kh\u00f4ng cho th\u1ea5y d\u1ea5u hi\u1ec7u c\u1ee7a ung th\u01b0 gan. AFP-L3 c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n sau khi \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh li\u1ec7u li\u1ec7u ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 hi\u1ec7u qu\u1ea3 hay ch\u01b0a.<\/p>\n<p>Tuy nhi\u00ean, ch\u1ec9 s\u1ed1 AFP-L3 c\u0169ng kh\u00f4ng ph\u1ea3i l\u00e0 ch\u1ec9 s\u1ed1 \u0111\u1ed9c l\u1eadp \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan v\u00e0 kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan \u0111\u1ec1u c\u00f3 m\u1ee9c \u0111\u1ed9 AFP-L3 t\u0103ng. Ngo\u00e0i ra, ch\u1ec9 s\u1ed1 AFP-L3 c\u0169ng c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c nh\u01b0 x\u01a1 gan do r\u01b0\u1ee3u.<\/p>\n<p>N\u1ebfu k\u1ebft h\u1ee3p s\u1eed d\u1ee5ng AFP v\u00e0 AFP-L3 trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, s\u1ebd gi\u00fap t\u0103ng \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a k\u1ebft qu\u1ea3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<h3>2.3. Ch\u1ec9 s\u1ed1 PIVKA II<\/h3>\n<p>Ch\u1ec9 s\u1ed1 <a href=\"https:\/\/www.vinmec.com\/vi\/ung-buou-xa-tri\/thong-tin-suc-khoe\/pivka-ii-dau-sinh-hoc-ung-thu-bieu-mo-te-bao-gan\/#:~:text=N%E1%BB%93ng%20%C4%91%E1%BB%99%20PIVKA%2DII%20b%C3%ACnh,99%25%20trong%20ch%E1%BA%A9n%20%C4%91o%C3%A1n%20HCC.\">PIVKA II<\/a> (Protein Induced by Vitamin K Absence or Antagonist-II) l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 sinh l\u00fd \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 ung th\u01b0 gan v\u00e0 d\u1ef1 b\u00e1o t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n.<\/p>\n<p>PIVKA II l\u00e0 m\u1ed9t protein \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o gan v\u00e0 c\u1ea7n c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a vitamin K \u0111\u1ec3 ho\u1ea1t \u0111\u1ed9ng. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 gan, s\u1ea3n xu\u1ea5t PIVKA II kh\u00f4ng c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o vitamin K n\u1eefa, d\u1eabn \u0111\u1ebfn t\u0103ng cao m\u1ee9c \u0111\u1ed9 c\u1ee7a ch\u1ec9 s\u1ed1 n\u00e0y trong m\u00e1u.<\/p>\n<p>Ch\u1ec9 s\u1ed1 PIVKA II th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng m\u00e1y \u0111o huy\u1ebft thanh v\u00e0 k\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o d\u01b0\u1edbi d\u1ea1ng ng\/mL. N\u1ed3ng \u0111\u1ed9 PIVKA-II b\u00ecnh th\u01b0\u1eddng l\u00e0\u00a0<b>&lt; 40 mAU\/mL<\/b>. <strong>V\u1edbi gi\u00e1 tr\u1ecb c\u1eaft l\u00e0 240 mAU\/mL<\/strong> th\u00ec PIVKA-II c\u00f3 \u0111\u1ed9 nh\u1ea1y l\u00e0 14-54% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u l\u00e0 95-99% trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan nguy\u00ean ph\u00e1t.<\/p>\n<p>Ch\u1ec9 s\u1ed1 PIVKA II \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 ung th\u01b0 gan v\u00e0 d\u1ef1 b\u00e1o t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong tr\u01b0\u1eddng h\u1ee3p c\u00e1c ch\u1ec9 s\u1ed1 AFP v\u00e0 AFP-L3 kh\u00f4ng c\u00f2n \u0111\u00e1p \u1ee9ng \u0111\u01b0\u1ee3c n\u1eefa. Ch\u1ec9 s\u1ed1 PIVKA II c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n sau khi \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh li\u1ec7u li\u1ec7u ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 hi\u1ec7u qu\u1ea3 hay ch\u01b0a.<\/p>\n<p>Tuy nhi\u00ean, nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a ch\u1ec9 s\u1ed1 PIVKA II l\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u cho ung th\u01b0 gan m\u00e0 c\u00f2n c\u00f3 th\u1ec3 t\u0103ng cao trong nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nh\u01b0 vi\u00eam gan, x\u01a1 gan, t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 vi\u00eam nhi\u1ec5m c\u1ea5p t\u00ednh.<\/p>\n<p>Ngo\u00e0i ra, c\u00e1c ch\u1ec9 s\u1ed1 AFP, AFP-L3 v\u00e0 PIVKA II th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng nhau \u0111\u1ec3 t\u0103ng \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a k\u1ebft qu\u1ea3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan.<\/p>\n<p>T\u00f3m l\u1ea1i, AFP, AFP-L3 v\u00e0 PIVKA II (DCP) l\u00e0 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n ung th\u01b0 gan. Vi\u1ec7c s\u1eed d\u1ee5ng ch\u00fang c\u00f9ng v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nh\u01b0 si\u00eau \u00e2m, CT scan v\u00e0 x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c v\u00e0 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng v\u00e0 d\u1ef1 b\u00e1o tri\u1ec3n v\u1ecdng \u0111i\u1ec1u tr\u1ecb. Trong \u0111\u00f3 AFP, AFP-L3 v\u00e0 PIVKA II (DCP) l\u00e0 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec<\/title>\n<meta name=\"description\" content=\"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-19T09:58:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-20T09:30:50+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1163190975-612x612-1-300x200.jpg\" \/>\n<meta name=\"author\" content=\"mitkaka mitkaka\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"mitkaka mitkaka\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/\",\"name\":\"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-19T09:58:01+00:00\",\"dateModified\":\"2023-04-20T09:30:50+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c\"},\"description\":\"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c\",\"name\":\"mitkaka mitkaka\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g\",\"caption\":\"mitkaka mitkaka\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/mitkaka2009mitkaka2009gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec","description":"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec","og_description":"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/","og_site_name":"Vinmec","article_published_time":"2023-04-19T09:58:01+00:00","article_modified_time":"2023-04-20T09:30:50+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1163190975-612x612-1-300x200.jpg"}],"author":"mitkaka mitkaka","twitter_card":"summary_large_image","twitter_misc":{"Written by":"mitkaka mitkaka","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/","name":"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-19T09:58:01+00:00","dateModified":"2023-04-20T09:30:50+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c"},"description":"Trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n, x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ...","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/gia-tri-cac-dau-an-sinh-hoc-trong-chan-doan-ung-thu-gan\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Gi\u00e1 tr\u1ecb c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c","name":"mitkaka mitkaka","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g","caption":"mitkaka mitkaka"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/mitkaka2009mitkaka2009gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22808"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=22808"}],"version-history":[{"count":5,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22808\/revisions"}],"predecessor-version":[{"id":24925,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22808\/revisions\/24925"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=22808"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=22808"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=22808"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}