Early detection of hepatocellular carcinoma associated with cirrhosis by combined assay of des-gamma-carboxy prothrombin and alpha-fetoprotein: a prospective study
Izuno, K.; Fujiyama, S.; Yamasaki, K.; Sato, M.; Sato, T.
Hepato-Gastroenterology 42(4): 387-393
1995
ISSN/ISBN: 0172-6390 PMID: 8586374 Document Number: 923
Background/Aims: To evaluate the usefulness of des-gamma-carboxy prothrombin (DCP) assay in a group at high risk for hepatocellular carcinoma (HCC). Patients and Methods: Plasma DCP and serum-alpha-fetoprotein (AFP) concentrations were prospectively measured in 137 patients with liver cirrhosis (LC). Results: During the mean observation period of 3.4 years, HCC developed in 35 patients (25.5%; yearly rate 7.5%), of whom 16 (45.7%) had a small tumor ltoreq 2cm in diameter. Eight patients (22.9%) had significantly elevated DCP at the time of HCC detection. However, all these tumors measured gt 2cm and were multiple or diffuse type. In cases with a tumor diameter ltoreq 2cm HCC was diagnosed by imaging and elevated AFP concentrations. In contrast, elevated DCP frequently leads to the detection of tumors gt 2cm or those of diffuse type, which are difficult to recognize with imaging. Conclusions: Thus, although DCP alone is not sensitive enough to detect early small liver cancers, the use of both markers and imaging in the follow-up of patients with LC might be beneficial.
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