Serology
Alpha-feto protein is the most important serological marker of HCC being raised in 85% of cases complicating cirrhosis. Levels up to 500 ng/ml are seen in acute and chronic hepatitis and alcoholic hepatitis; levels above this imply HCC or a germ cell tumour.
Other serological indicators:
- carcino-embryonic antigen - not specific for HCC. High in liver metastases.
- serum ferritin - an acute phase reactant. May be raised in HCC due to production of ferritin by tumour. Not specific.
- Des-gama-carboxyprothrombin (DGC) - a vitamin K dependent prothrombin precursor. Levels may be low as only the normal hepatocyte can synthesise DGC.
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