DETERMINATION OF PLASMA UROKINASE-TYPE PLASMINOGEN-ACTIVATOR ANTIGEN IN PATIENTS WITH PRIMARY LIVER-CANCER - CHARACTERIZATION AS TUMOR-ASSOCIATED ANTIGEN AND COMPARISON WITH ALPHA-FETOPROTEIN

We determined the plasma levels of urokinase-type plasminogen activato r (u-PA) antigen and alpha-fetoprotein (AFP) in 44 patients with diffe rent stages of liver cirrhosis and in 29 patients with liver cirrhosis -based primary liver cancer at the time of first clinical detection of the malignant disease. Sensitivity values of u-PA and AFP in detectin g primary liver cancer were 57 and 62%, respectively, and specificity values were 95 and 86%, respectively. A combination of both markers le d to a significant increase of sensitivity to 89.7%. The specificity o f the combination of both markers was 97.3%. In tumor patients with un ilocular disease and tumor patients with multicentric disease and/or m etastatic spread, similar sensitivity values could be obtained with bo th markers. Therefore, a combination of u-PA and AFP can increase the accuracy of detection of primary liver cancer, especially in chronic l iver diseases known to be predisposing for primary liver cancer, eg., liver cirrhosis of long duration.