This study was undertaken to see if serum ferritin could serve as a co
mplementary marker to a-fetoprotein (AFP) for hepatocellular carcinoma
(HCC). We studied 80 patients with HCC, 72 with benign liver diseases
(BLD) and 70 healthy adults. At the threshold of 400 ng/ml, a sensiti
vity of 71.3% was achieved for ferritin in HCC patients, as against 58
.8% for AFP at the 200 ng/ml cut-off; ferritin and/or AFP were raised
in 88.8% of such patients. The specificity of ferritin for HCC compare
d to BLD, however, was only 48.6%, as against 97.2% for AFP. Overall,
the efficiency of ferritin measurements in HCC was 60.5% against 77.0%
for AFP. Raised ferritin did not correlate with raised AFP or hepatit
is B surface antigen positivity; ferritin levels correlated with aspar
tate transaminase and alanine transaminase but not with alkaline phosp
hatase or gamma-glutamyltransferase. Our results indicate that ferriti
n measurements alone are not sufficient to distinguish HCC from BLD; h
owever, an elevated ferritin level in high-risk patients should raise
the level of suspicion of HCC.