SERUM ALPHA-FETOPROTEIN LEVELS AND MICROHETEROGENEITY IN PATIENTS WITH DIFFERENT LIVER-DISEASES

Serum α-fetoprotein levels were determined in patients (268) with liver disease. Markedly elevated concentrations (>100 μg/l) were found in twelve patients with malignant tumours and two with cirrhosis. Molecular variants of α-fetoprotein were distinguished by lectin affinity chromatography of these sera. Reversible binding to concanavalin A (86 ± 5%) and to lentil agglutinin (61 ± 19%) conformed to expected values for primary hepatocellular carcinoma except in one patient with a metastatic carcinoma whose α-fetoprotein binding to concanavalin A was similar to non-liver α-fetoprotein (44 ± 13%), and the two patients with cirrhosis in whom binding to lentil agglutinin was typical for benign liver disorders (<20%). Since low levels of serum α-fetoprotein and non-characteristic α-fetoprotein binding patterns assisted in the regrouping of eleven out of 24 patients initially thought to have primary hepatocellular carcinoma, it was concluded that α-fetoprotein determination and lectin affinity chromatography are helpful in distinguishing primary hepatocellular carcinoma from metastatic and benign liver diseases. Slight increases in the α-fetoprotein level in the presence of serum hepatitis B surface antigen indicated seven patients at risk for primary hepatocellular carcinoma who should be monitored frequently. © 1990.