Value of serum C-reactive protein measurement in the detection of hepatocellular carcinoma superimposed on liver cirrhosis.
We investigated whether, in Italian patients, C-reactive protein (CRP) determination could be considered a useful adjunct, complementary to alpha 1-fetoprotein, in the detection of liver cancer. CRP was determined by particle-enhanced nephelometry in 171 subjects (102 male, 69 female). Fifty-five patients had mild chronic liver disease (CLD), 45 cirrhosis (CIR), 38 hepatocellular carcinoma (HCC); 33 subjects were healthy controls. Patients with HCC and CIR had higher CRP levels (P < 0.05) than those found in patients with CLD and controls. CRP higher than 5 mg/l was found in 30/38 (78.9%) patients with HCC, 28/45 (62.2%) patients with CIR, 16/55 (29.1%) patients with CLD (chi 2 56.0, P < 0.0001). Sensitivity, specificity and diagnostic accuracy of CRP in diagnosing HCC with respect to CLD+CIR were: 78.9%, 56.0% and 34.9%. However, when considered only in the subgroup of patients with alpha 1-fetoprotein below or equalling 30 ng/ml, they were 50.0%, 54.3% and 4.3% respectively. In conclusion, CRP concentration is frequently elevated in patients with HCC, however, it does not seem to improve the ability of alpha 1-fetoprotein to discriminate HCC from CIR.
Fabris
C
C
Cattedra di Medicina Interna, Università degli Studi di Udine, Italy.
Pirisi
M
M
Soardo
G
G
Falleti
E
E
Pezzetta
F
F
Vitulli
D
D
Toniutto
P
P
Bortolotti
N
N
Gonano
F
F
Bartoli
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications*; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D002097:C-Reactive Protein