A clinical and biochemical study on tissue polypeptide antigen (TPA) in non-malignant hepatic disorders

The behaviour of the tumour marker TPA was studied in 160 patients with benign diffuse liver diseases which underwent a thorough clinical and biochemical evaluation. Abnormal serum levels were found in 71.9% of the 160 patients, 87.2% of the 86 cirrhotics, and 98.4% of the 61 cirrhotics with elevated aspartate aminotransferase (ASAT) levels. TPA correlated with numerous clinical and biochemical markers of liver disease, serum ASAT being the most significant one (r = 0.63, p < 0.00001). TPA values were higher in cirrhotics than in non-cirrhotics (p < 0.0001) and in the patients with increased ASAT as compared with those with normal ASAT (p < 0.0001). In liver disease the cut-off level had to be raised five-fold to allow 10% abnormal values. This fact severely limits the usefulness of TPA in oncologic patients who also have liver disease. Cytolysis and/or liver regeneration appear to play an important role in the increase of TPA in these patients although other mechanisms such as impaired metabolism due to hepatocellular insufficiency also may be involved.