DISCRIMINANT FUNCTION-BASED ON SERUM ANALYTES DIFFERENTIATES HEPATOCARCINOMA FROM SECONDARY LIVER NEOPLASIA

Hepatocellular carcinoma (HC) is often difficult to distinguish from s econdary liver neoplasia (SLN) by physical and imaging diagnostic proc edures alone. To this aim we have extended and improved a laboratory a pproach based on a serum lactate dehydrogenase isoenzyme ratio (LD4:LD 5) by adding the carcinoembryonic antigen: alpha-fetoprotein ratio, al kaline phosphatase, and serum iron concentrations to obtain a highly e fficient discriminant function. In two successive cohorts, for a total of 102 patients, all histologically diagnosed, with a prevalence of H C vs SLN of 3.1, we correctly classified 96% of cases (100% of SLN cas es). Subsequent verification with the jackknife reallocation statistic al algorithm confirmed these results. In conclusion, this discriminant function based on simple laboratory assays of a few analytes is an im portant tool in solving a diagnostic dilemma in cases of liver neoplas ia.