Serum tumor markers in patients with hepatocellular carcinoma: diagnosis of alpha-fetoprotein -low or -negative patients.
The presence of specific gamma-glutamyl transpeptidase isoenzyme (gamma-GTPI) and variant alkaline phosphatase (VAALP) were concurrently determined, and levels of basic fetoprotein (BFP) and carcinoembryonic antigen (CEA) in addition to alpha-fetoprotein (AFP) were measured in 144 hepatocellular carcinoma (HCC) patients in order to evaluate the diagnostic value of these tumor markers with respect to AFP-low or -negative patients and the tumor stage. Serum AFP levels below 400 ng/ml, commonly seen in sera of hepatobiliary diseases other than HCC, were noted in 42% of the patients. The diagnostic usefulness was increased by combination assay of these markers except for CEA. A definitive diagnosis of HCC could be made in 78% of the patients by a combination of gamma-GTPI, VAALP and AFP. Moreover, a diagnosis of malignancy could be made in 87% of cases by the inclusion of BFP. The prevalence of BFP and CEA increased in proportion to the tumor stage, whereas that of AFP and gamma-GTPI were independent of stage and were high even in patients in comparatively early stages. Furthermore, secreting type markers such as AFP and gamma-GTPI were relatively useful for diagnosis of HCC when the lesions were still small.
Sawabu
N
N
Wakabayashi
T
T
Ozaki
K
K
Toya
D
D
Yoneshima
M
M
Kidani
H
H
Hattori
N
N
Ishii
M
M
D000469:Alkaline Phosphatase / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D005326:Fetal Proteins / Q000378:metabolism; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D000509:alpha-Fetoproteins / Q000378:metabolism*; D005723:gamma-Glutamyltransferase / Q000097:blood
D002272:Carcinoembryonic Antigen; D005326:Fetal Proteins; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase