Evaluation of the combined assay of alpha-feto protein and gamma-glutamyl transpeptidase isoenzyme II in the diagnosis of primary hepatic carcinoma

Serum alpha-feto protein (AFP) and gamma-glutamyl transpeptidase isoenzyme II (gamma-GTP-II) were assayed in 104 patients with primary hepatic carcinoma (PHC), gamma-GTP-II had a higher specificity of 95.7%, while AFP a higher sensitivity of 84.6%. There was no significant difference in the positive diagnostic rate of the two markers in patients with AFP > or = 400 micrograms/L and with AFP < 400 micrograms/L. Nor was there any difference if the patients were divided into four groups according to the serum AFP levels of 200 micrograms/L, 400 micrograms/L and 1,000 micrograms/L. Altogether 97 of the 104 PHC patients were detected when the two markers were assayed in combination (40 out of 42 PHC patients with AFP > or = 400 micrograms/L and 57 out of 62 PHC patients with AFP < 400 micrograms/L). These results suggest that combined assay of the two serum PHC markers will increase the detecting rate of PHC and be of value especially in those patients with normal or low serum level of AFP.