Tumor markers of hepatocellular carcinoma with special reference to diagnostic efficacy of combination of these markers and relation to its stages

: The authors concurrently determined four markers consisting of novel gamma-GTP isoenzyme (Novel gamma-GTP), variant alkaline phosphatase (VAALP), basic fetoprotein (BFP) and CEA in addition to AFP in 144 patients having HCC. Serum AFP levels below 400ng/ml, a condition commonly seen in sera of hepatobiliary diseases other than HCC were obtained in 60 our of patients, or 42%. There was little correlation among positivities of these markers, and the diagnostic usefulness was increased by combination assay of these markers, except in the case of CEA. Specific diagnosis of HCC could be made in 78% by a combination of Novel gamma-GTP and VAALP in addition to AFP. Moreover, diagnosis of an existing malignancy could be made in 87% by BFP in addition to AFP, Novel gamma-GTP and VAALP. Positive ratios of BFP and CEA increased in proportion to staging, whereas those of AFP and Novel gamma-GTP were independent of the stage and relatively high even in patients within the early stage. In general, incidences of these markers were relatively lower in patients having small HCC, however, markers of a secreting type such as AFP and Novel gamma-GTP were relatively useful for early diagnosis of HCC.