title: Small HCCs identified by screening.
abstract: BACKGROUND
  Survival in HCC depends on diagnosis at early tumor stage, best achieved through surveillance radiology. There is also a need for complementary serum tests.
  
  
  METHODS
  We evaluated baseline liver function parameters from a cohort of 231 HCC patients who were diagnosed by surveillance. They were ordered according to their tumor mass and trends in the data were analyzed.
  
  
  RESULTS
  Trends in serum GGTP levels increased linearly with increases in small tumor mass, but the patterns for AFP levels were more complex and elevated only with larger tumor mass. ALKP levels were elevated in association with small tumors and further increased with increasing tumor mass. The relationships of serum AFP to GGTP, of albumin to bilirubin and of ALKP to bilirubin, helped identify tumor mass phenotypes. There was an especially important relationship between serum bilirubin and AFP, suggesting that HCC growth and liver factors were interdependent.
  
  
  CONCLUSIONS
  Small HCCs demonstrated several phenotypic sub-groups, with serum GGTP and ALKP increasing and albumin decreasing in many patients with increasing tumor mass.
authors.affiliation: Center for Clinical Pharmacology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Petr
authors.initials: P
authors.lastname: Pancoska
authors.forename: Massimo
authors.initials: M
authors.lastname: De Giorgio
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.forename: Brian I
authors.initials: BI
authors.lastname: Carr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D015898:Tomography Scanners, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin