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Serum ferritin and AFP concentration in 75 patients with hepatocellular carcinoma (HCC) and 150 patients with liver cirrhosis (LC) were measured by radioimmunoassay (RIA). Clinical significance of the elevated serum ferritin was evaluated comparing with serum AFP as follows.1) Mean values with standard errors of serum ferritin in HCC and LC were 378±82 ng/ml and 168±67ng/ml respectively and the difference was not significant. The ratio of serum ferritin to serum iron and s-GOT were, on the other hand, significantly higher in HCC than in LC. (P<0.05)2) The high values of serum ferritin over 300ng/ml were obtained in 19 of 26 patients with HCC (73.1 %) whose AFP levels were less than 200ng/ml and in 21 cases of 150 patients with LC (14.0%) respectively.3) In the 38 cases with HCC, histological classification was carried out according to Edmondson and Steiners' classification. In the majority of patients, the serum ferritin levels showed less than 300ng/ml in the grade II or grade III group and more than 300ng/ml in the grade I or grade IV group respectively.4) Thirteen patients with LC who transformed to HCC were classified into 4 types according to changes of serum ferritin and AFP levels. In the first type, neither serum ferritin nor AFP showed abnormal values through the clinical course. Only one patient showed this type. In the second type, AFP increased remarkably leaving ferritin level low. Eight patients (61.5%) were included in this type. In the third type, serum ferritin increased remarkably leaving AFP level low. In the last type, both serum ferritin and AFP increased remarkably. Two patients were included in the both third and fourth groups respectively.In summary, it is indispensable to measure the serum ferritin level for diagnosing AFP-negative HCC.
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