[Early diagnosis of alpha fetoprotein nonproducing primary liver cancer]

A comparative study on 150 cases of alpha fetoprotein (AFP) nonproducing primary liver cancer (PLC) in subclinical and moderate stages and 133 cases of intrahepatic solid space-occupying lesion (SOL) other than PLC was undertaken. All were operated and proven by pathology. The results indicated that in the intrahepatic SOL patients with negative serum AFP the diagnosis of PLC could be established if any one of the following items was confirmed: (1) Definite evidence of liver cirrhosis; (2) Hypoecho or inhomogeneous echo sonodensity on ultrasonography plus positive serum HBsAg; (3) Positive 99mTc-PMT liver scan (4) No overfilling of SOL on blood pool scintiscan plus positive HBsAg; (5) No enhancement after injection of contrast medium on computed tomography plus positive HBsAg. The positive rates of the above items in PLC and non-PLC groups were: (1) 73.2% vs. 0.9%, (2) 48.1% vs. 9.6%, (3) 64.3% vs. 14.3%, (4) 27.3% vs. 3.9% and (5) 34.6% vs. 0%, respectively. Statistically, these differences were significant. In conclusion, according to the above mentioned criteria, detection rate of over 90% with over 85% specificity can be obtained for AFP negative PLC.