Diagnostic usefulness of acute-phase protein measurement in hepatocellular carcinoma.
To compare the diagnostic usefulness as markers of hepatocellular carcinoma (HCC) of alpha1-antitrypsin, C-reactive protein, and alpha1-acid glycoprotein (all determined by nephelometric methods), we studied 132 subjects (74 male, 58 female): 43 had mild chronic liver disease, 32 cirrhosis, 24 HCC; 33 were controls. A total of 29.2% of the patients with HCC had alpha1-acid glycoprotein > 100 mg/dl, 75.0% had alpha1-antitrypsin > 220 mg/dl, 70.8% had C-reactive protein > 5 mg/L. In cirrhotics, frequencies were 3.1, 50.0 and 59.4%, respectively; in patients with mild chronic liver disease, 14.0, 11.6, and 32.6% (chi2 12.3, p < 0.01; chi2 47.3, p < 0.0001; chi2 38.0, p < 0.0001, respectively). alpha1-fetoprotein performed better than all acute-phase proteins. We conclude that, due to their low specificity and/or sensitivity, none of the three acute-phase reactants tested can be recommended for diagnostic use as biological markers of HCC in Western patients.
Fabris
C
C
Cattedra di Medicina Interna, Medical School, University of Udine, Udine, Italy.
Pirisi
M
M
Soardo
G
G
Toniutto
P
P
Falleti
E
E
Vitulli
D
D
Pezzetta
F
F
Gonano
F
F
Bartoli
E
E
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000032:analysis
D000209:Acute-Phase Proteins; D009961:Orosomucoid; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein