The serum concentration of ?-fetoprotein (AFP) was measured by radioimmuunoassay in 30 cases of clinical or biopsy-proven acute viral hepatitis, 10 cases of biopsy-proven active chronic hepatitis, 30 cases of decompensated liver cirrhosis, 43 cases of biopsy proven primary liver cancer, 7 cases of secondary liver cancer (from stomach), 10 cases of the miscellaneous diseases,´ and 70 normal adults to evaluate the critical value of serum AFP concentration as a diagnostic est for theprimary liver cancer. Double- diffusion test of serum AFP were also done, and the results were. compared to ´those obtained by radioimmunoassay.
The results obtained were summarized as followings:
1. Serum AFP concentration in normal Korean adults was in a range of 0 μg/100 ml to 2.0 μg/ 100 ml with an exception of 6.7 μg/100 ml in a case (99.99% under 2.0 μg/100m1, p<0.00001).
2. Mild elevation of serum AFP concentration, but under 50.0 μg/100 ml of serum AFP value in all as compared to that of normal population was observed in acute and chronic hepatitis, liver cirrhosis secondary liver cancer and miscellaneous cases such as liver abscess and cancer of terine cervix or gallbladder.
3. Serum AFP concentration in the patients with primary liver cancer was shown to ie in a range of 2.0 μg/100 ml to 90, 000 μg/100 ml with median value of 3, 100 μg/100 ml. And of 43 cases studied, 40 cases (93. 0%) showed their serum AFP concentration above the value of 60.0 μg/ 100 ml.
4. Serum AFP detection by, immunodiffusion assay was shown to be positive. at the rite of 51.2% (22 out, of 43) in the patients with primary. liver cancer, but not at all in the other groups studied and normal controls. The serum concentration at which AFP cann be detected. by immunodiffusion technique. was proved to be above the concentration of 2.2 mg/100 ml of AFP by serial dilution of a heavily positive AFP serum sample.
5. It is believed that AFP determination by radioimmunoassay should be done in the patients with chronic parenchymal liver diseases who are suspected for the occult hepatoma and in whom the initial test for AFP by mmunodiffusion was negative, and close clinical observation and sequential determinations of AFP by radioimmunoassay should be made for the confirmation of primary liver cancer in whom serum concentration of AFP was shown to be above the value of 60.0 μg/100ml.
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