Coagulation Assays as Diagnostic Markers of Hepatocellular Carcinoma

Summary

With the aim of improving the biological diagnosis of hepatocellular carcinoma (HCC), alpha-fetoprotein (AFP), des-gamma-carboxyprothrombin (DCP) and factor V levels were assayed in 119 patients with HCC and 60 cirrhotic patients without HCC. Among the patients with HCC, increased levels of AFP (>300 ng/ml) and of DCP (>15 mU/ml) vveie ubseived in 36% and 69% of the cases, respectively. None of the 60 patients without TTCC had increased AFP, and one had abnormal DCP; in this patient, DCP level returned to normal value after vitamin K₁ injection. No significant correlation was found between increased AFP and DCP, thus indicating that the two tests complement each other for the diagnosis. A factor V level higher than expected from the reduced prothrombin time test of the patient was detected in 50% of patients with HCC and only 7% of those without HCC. No correlation was found between increased factor V and abnormal AFP or DCP The thrombin time, fibrinogen activity to antigen ratio, and polymerization index failed to differentiate between cirrhosis and HCC. We conclude that AFP, DCP and factor V may give complementary informations in the diagnosis of HCC, one of these markers at least being positive in 88% of the patients.

Keywords

Coagulation assays - Hepatocellular carcinoma - Decarboxy-prothrombin - Proaccelerin

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