Diagnosisof Heparocellular Carcinoma by Serial Determination of Serum α-Fetoprotein Concentration

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The development of sensitive techniques for determination of serum α-fetoprotein (S-AFP) concentration, such as radioimmunoassay (RIA), enable us to detect hepatocellular carcinoma (HCC) in an early stage. This communication describes the clinical significance of S-AFP determination by RIA in the diagnosis of HCC.The sensitivity of the AFP assay with α-Feto-125 kit produced by the Dainabot RI laboratories was over 2.5ng/ml. Reproducivility of the kit was satisfactory; coefficients of variation showed 6-10% in within assays and 13% in between assays. The mean value and standard deviation of S-AFP in the sera of 30 cases of healthy controls was 5.6±2.6ng/ml, respectively.When the serum with a high level of S-AFP (2.9×105ng/ml) was diluted with normal horse serum, the actual concentration of AFP in the diluted serum were consistent with those determined. Thus, normal horse serum was employed to dilute the sera with high levels of AFP.Levels of S-AFP were over 2000ng/ml in 75.5% of 49 cases with HCC, in 0.64% of 157 patients with hepatitis and cirrhosis of the liver, and 3.8% of 52 cases of metastatic gastric cancer to the liver. In 20 patients with HCC, levels of S-AFP ranged widely from 7.5 to 9.5×105ng/ml. In serial determination of S-AFP in the clinical course of patients such as those with S-AFP over 2000ng/ml, the continuous increase of AFP was strongly suggestive of the presence of HCC. In 4 cases of 20 cases of HCC, S-AFP levels remained under 300ng/ml. Histological examination these 4 cases with HCC showed only Classes I and II, and no III in Edmondson's classification. Other cases of HCC with S-AFP levels over 300ng/ml showed Edmondson's Classes II and III.
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Diagnosisof Heparocellular Carcinoma by Serial Determination of Serum α-Fetoprotein Concentration

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