VALUE OF SERUM C-REACTIVE PROTEIN MEASUREMENT IN THE DETECTION OF HEPATOCELLULAR-CARCINOMA SUPERIMPOSED ON LIVER-CIRRHOSIS

We investigated whether, in Italian patients, C-reactive protein (CRP) determination could be considered a useful adjunct, complementary to alpha(1)-fetoprotein, in the detection of liver cancer. CRP was determined by particle-enhanced nephelometry in 171 subjects (102 male, 69 female). Fifty-five patients had mild chronic liver disease (CLD), 45 cirrhosis (CIR), 38 hepatocellular carcinoma (HCC); 33 subjects were healthy controls. Patients with HCC and CIR had higher CRP levels (P<0.05) than those found in patients with CLD and controls. CRP higher than 5 mg/l was found in 30/38 (78.9%) patients with HCC, 28/45 (62.2%) patients with CLR, 16/55 (29.1%) patients with CLD (X(2) 56.0, P<0.0001). Sensitivity, specificity and diagnostic accuracy of CRP in diagnosing HCC with respect to CLD + CIR were: 78.9%, 56.0% and 34.9%. However, when considered only in the subgroup of patients with alpha(1)-fetoprotein below or equalling 30 ng/ml, they were 50.0%, 54.3% and 4.3% respectively. In conclusion, CRP concentration is frequently elevated in patients with HCC, however, it does not seem to improve the ability of alpha(1)-fetoprotein to discriminate HCC from CIR.