Evaluation of alpha-fetoprotein assay in ascitic fluid for the diagnosis of hepatocellular carcinoma.
Ascites and hepatocellular carcinoma are frequently associated. We evaluated the usefulness of alpha-fetoprotein assay in ascitic fluid versus the serum assay, for the diagnosis of hepatocellular carcinoma, in 125 patients with peritoneal effusions (31 patients with hepatocellular carcinoma, 14 with extra-hepatic malignancies and 80 with a benign effusion). Albumin and total protein were also assayed and cytological analysis of the ascitic fluid performed. Alpha-fetoprotein appeared to be lower in ascitic fluid than in serum. For a diagnostic specificity of 95%, the thresholds were 18.9 microg/l in serum and 4 microg/l in ascitic fluid and the diagnostic sensitivity of alpha-fetoprotein was identical in serum and ascitic fluid (67.7%). Various ratios between alpha-fetoprotein and albumin or total protein did not enhance the diagnostic performance. Thus alpha-fetoprotein concentration in ascitic fluid reflected the serum concentration and proved to be of similar value for the diagnosis of hepatocellular carcinoma, providing that the appropriate thresholds are considered.
Miédougé
M
M
INSERM CJF 96-02, IFR30, Faculté de Médecine Purpan, Université Paul Sabatier, Toulouse, France.
Salama
G
G
Barange
K
K
Vincent
C
C
Vinel
J P
JP
Serre
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D001202:Ascitic Fluid / Q000737:chemistry*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D000509:alpha-Fetoproteins / Q000032:analysis*
D000418:Albumins; D000509:alpha-Fetoproteins