Serum a-Fetoprotein as a Biochemical Marker for Hepatocellular Carcinoma

The demonstration of a-fetoprotein (αFP) has proven value in the diagnosis of hepatocellular carcinoma, but little is known of the dynamics of this protein during the course of the disease. A sensitive, quantitative test has been used to measure αFP serum levels in 90 Ugandan patients with histologically proven hepatocellular carcinoma. By the standard double diffusion immunological test, 71% of the patients were αFP positive. The quantitative values were spread over a wide range from 0.5 to 4000 μg/ml, with a median value of 71 μg/ml. Forty-one patients (26 before treatment and 15 during chemotherapy) were followed with serial serum αFP determinations. There was a remarkable stability in the level for each patient, which levels showed little fluctuation during the time they were followed, regardless of the initial level. The only consistent change was a slight tendency for the serum αFP to rise as the disease progressed. A striking difference was noted in four patients receiving partial hepatectomy who showed a rapid decline in serum αFP and became negative postoperatively.