DIAGNOSTIC EFFICACY OF PLASMA UROKINASE-TYPE PLASMINOGEN-ACTIVATOR AND PLASMINOGEN-ACTIVATOR INHIBITOR-2 IN DIFFERENTIATION OF HEPATOCELLULAR-CARCINOMA FROM CIRRHOSIS

We determined the plasma antigen levels of urokinase-type plasminogen activator(u-PA) and plasminogen activator inhibitor 2(PAI-2) in 41 pat ients with hepatocellular carcinoma and 28 patients with different sta ges of liver cirrhosis. No significant differences of u-PA and PAI-2 l evels were calculated between the two groups of tumor patients (HCC) a nd liver cirrhosis without tumor (non-HCC). Within both study groups, no significant differences were found in u-PA and PAI-2 levels of the different Child categories. Discriminative functions of both u-PA and PAI-2 (total error count estimates of 43.1% and 43.6%, respectively), were low compared to that (29.0%) of alpha-fetoprotein (AFP). The comb inations of AFP and u-PA lowered the total error rate (21.9%) more tha n that of each marker alone. However, whether plasma u-PA and PAI-2 ma y be considered as a risk factor further investigation was needed and our findings raise the question as to whether these markers could be c onsidered as useful screening markers for earlier detection of HCC in liver cirrhosis because discriminant functions of u-PA and PAI-2 were not significant. Sensitivities and specificities of u-PA and PAI-2 wer e also nor high enough, resulting in the ranges of total diagnostic ef ficiency from 43% to 50%, and, from 49% to 63%, respectively, at diffe rent cut-off values. No direct relationship was detected between AFP a nd u-PA, between AFP and PAI-2, and between u-PA and PAI-2.