Alcoholic liver disease. Absence of alpha-fetoprotein elevations in the recovery phase

Serum alpha-fetoprotein (AFP) may be detected in patients with nonneoplastic liver diseases such as massive hepatic necrosis, viral hepatitis, and experimental liver injury, AFP levels have not been serially assessed in patients with alcoholic liver disease, with or without cirrhosis, during the period following cessation of alcohol. Thirty-two such patients were studied with weekly AFP determinations, an average of five such measurements being obtained per patient. The severity of alcoholic liver disease in this group varied from mild alcoholic hepatitis to advanced cirrhosis, and overall mortality was 31%. Thirty-one of the 32 patients had consistently negative AFP determinations. One patient with persistently elevated AFP levels proved to have hepatoma at autopsy. This study failed to detect AFP evelations in a group of patients with alcoholic liver disease and suggests that positive AFP determinations in such patients shoudl raise the question of underlying hepatocellular carcinoma.