Clinical evaluation of several tumor markers in the diagnosis of primary hepatic cancer

Abstract

AIM: To evaluate the significance of alpha fetoprotein (AFP). Gamma-glutamyltransferase (GGT). Carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in diagnosis of primary hepatic cancer.

METHODS: Thirty six patients with liver carcinoma (male 26, female 10, aged 29-72 years), 6 with hepatic metastasis of gastrointestinal cancer (all male, aged 37-69 years), 62 with benign liver diseases (male 53, female 9, aged 32-71 years) and 222 without liver diseases (male 152, female 70, aged 22-76 years) were studied. Blood samples were taken by venipuncture. Serum was separated and frozen at -20 °C until the analysis was made. AFP, CEA and CA125 were measured by RIA.

RESULTS: Serum AFP in liver cancer (476.3 ± 181.4 μg/L) was significantly higher than that in hepatic metastasis of gastrointestinal cancer, benign liver diseases and monhepatic diseases (P < 0.01). Serum GGT in liver cancer was 621.1 ± 289.9 w/L, significantly higher than that in the other groups (P < 0.05). CA125 level in liver cancer (236.3 ± 127.2 U/L) was markedly higher than that in benign liver diseases and nonhepatic diseases (P < 0.01), but no significantly difference was found in hepatic metastasis of gastroentestinal cancer (219.4 ± 143.7 U/L). Serum CEA in liver cancer (8.8 ± 2.1 μg/L) was markedly lower than that in hepatic metastasis of gastroentestinal cancer (32.7 ± 7.2 μg/L) (P < 0.01). The sensitivity of AFP, GGT, CA125 and CEA in the diagnosis of liver cancer was 72.2%, 88.9%, 63.9% and 11.1% repectively; their specificity was 93.1%, 71.1%, 78.2% and 65.8% respectively. The diagnostic sensitivity and specificity of simultaneous detect ion of AFP, GGT and CA125 in liver cancer were 91.7% and 88.4% respectively.

CONCLUSION: AFP is superior to GGT, CA125 and CEA in the diagnosis of liver cancer; simultaneous detection of AFP, GGT and CA125 might increase the diagnositic sensitivity and specificity of liver cancer.

Key Words: Liver neoplasms/diagnosis; Tumor markers, Biological; Gamma-glutamyltransferase; Carcinoembryonic antigen; Alpha globulins; Serodiagnosis