SERUM ALPHA-L-FUCOSIDASE ACTIVITY AND TUMOR SIZE IN HEPATOCELLULAR-CARCINOMA

The serum level of alpha-L-fucosidase activity has been suggested as a useful marker in the diagnosis of hepatocellular carcinoma, although the precise mechanism behind the elevation of this parameter has not b een determined, We found that the serum alpha-L-fucosidase activity le vel was significantly higher in 67 patients with hepatocellular carcin oma (695.1 +/- 245.5 nmol/ml/hr) than in 47 patients with cirrhosis (3 89.1 +/- 188.2 nmol/ml/hr; p < 0.001) and in 54 controls (202.0 +/- 10 4.6 nmol/ml/hr; p < 0.001). However, alpha-L-fucosidase activity was n ot correlated with tumor size (r = 0.134), whereas the alpha-fetoprote in level was correlated with tumor size (r = 0.580, p < 0.001). When 5 15.8 nmol/ml/hr was taken as the cutoff value (mean value in the contr ols plus 3 standard deviations), alpha-L-fucosidase activity was above the cutoff value in 12 of the 17 patients with a hepatocellular carci noma less than 2 cm in diameter, in 28 of the 37 patients with a hepat ocellular carcinoma less than 3 cm in diameter and in 52 of the 67 pat ients with hepatocellular carcinoma. In contrast, only 10 of the 47 pa tients with cirrhosis had levels above the cutoff value. These finding s suggest that an increase in serum (alpha-L-fucosidase activity in pa tients with cirrhosis may be a marker for detecting a hepatocellular c arcinoma, especially a small tumor, because alpha-fetoprotein and des- gamma-carboxy-prothrombin are less promising as tumor markers.