Summary
The presence of specific gamma-glutamyl transpeptidase isoenzyme (γ-GTPI) and variant alkaline phosphatase (VAALP) were concurrently determined, and levels of basic fetoprotein (BFP) and carcinoembryonic antigen (CEA) in addition to α-fetoprotein (AFP) were measured in 144 hepatocellular carcinoma (HCC) patients in order to evaluate the diagnostic value of these tumor markers with respect to AFP-low or -negative patients and the tumor stage.
Serum AFP levels below 400 ng/ml, commonly seen in sera of hepatobiliary diseases other than HCC, were noted in 42% of the patients. The diagnostic usefulness was increased by combination assay of these markers except for CEA. A definitive diagnosis of HCC could be made in 78% of the patients by a combination of γ-GTPI, VAALP and AFP. Moreover, a diagnosis of malignancy could be made in 87% of cases by the inclusion of BFP. The prevalence of BFP and CEA increased in proportion to the tumor stage, whereas that of AFP and γ-GTPI were independent of stage and were high even in patients in comparatively early stages. Furthermore, secreting type markers such as AFP and γ-GTPI were relatively useful for diagnosis of HCC when the lesions were still small.
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Wepsic HT, et al: Alpha-fetoprotein and its relevance to human disease. Gastroenterology 77: 787, 1979
Alpert E: Human α1-fetoprotein. “Progress in Liver Disease” vol 5, by Popper H, Schaffner F. Grune & Stratton, New York, 1976, p 337
Sawabu N, et al: Clinical evaluation of specific γ-GTP isoenzyme in patients with hepatocellular carcinoma. Cancer 51:327, 1983
Okuda K, et al: Clinicopathological studies of minute hepatocellular carcinoma. Gastroenterology 73: 109, 1977
Sawabu N, et al: Novel γ-GTP isoenzyme specifically found in sera of patients with hepatocellular carcinoma. Gann 69: 601, 1978
Toya D, et al: Purification of γ-GTP from human hepatocellular carcinoma, and comparison of γ-GTP with the enzyme from human kidney. Ann NY Acad Sci 417: 86, 1983
Warnock ML, et al: Variant alkaline phosphatase in human hepatocellular cancers. Clin Chim Acta 24: 5, 1969
Ishii M: A new carcinoembryonic protein characterized by basic property. Scand J Immuno 8 (Suppl 8): 611, 1978
Nakagen M, et al: Evaluation of alkaline phosphatase (ALP) isoenzyme separated by polyacrylamide gradient gel electrophoresis — Specific reference to variant ALP. Jpn J Gastroent 17: 1930, 1980
Ishii M: Characterization of basic fetoprotein and clinical usefulness of basic fetoprotein for immunodiagnosis of human cancer. “Carcinoembryonic Proteins ” vol 1, by Lehmann FG. Elsevier North Holland, Amsterdam, 1979, p 333
Suzuki H, et al: Tumor specific alkaline phosphatase in hepatoma. Ann NY Acad Sci 259: 307, 1975
Higashino K, et al: Hepatocellular carcinoma and a variant alkaline phosphatase. Ann Int Med 83: 74, 1975
Okuda K: Clinical aspect of hepatocellular carcinoma: Analysis of 134 cases. “Hepatocellular carcinoma” by Okuda K, Peters RL. Wiley Medical, New York, 1976, p 387
Hirai H: A collaborative clinical study of carcinoembryonic antigen in Japan. Cancer Res 37: 2267, 1977
Ishii M: Clinical usefulness of basic fetoprotein for immunodiagnosis of human cancer. “Compendium of assays for immunodiagnosis of human cancer” by Heberman R. Elsevier North Holland, New York, 1979, p 45
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Sawabu, N., Wakabayashi, T., Ozaki, K. et al. Serum tumor markers in patients with hepatocellular carcinoma: Diagnosis of α-fetoprotein -low or -negative patients. Gastroenterol Jpn 20, 209–215 (1985). https://doi.org/10.1007/BF02774706
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DOI: https://doi.org/10.1007/BF02774706