CLINICAL-EVALUATION OF URINARY TRANSFORMING GROWTH-FACTOR-BETA-1 AND SERUM ALPHA-FETOPROTEIN AS TUMOR-MARKERS OF HEPATOCELLULAR-CARCINOMA

To evaluate the diagnostic application of urinary transforming growth factor-beta 1 (TGF-beta 1) and serum alpha-feloprotein (AFP) levels in hepatocellular carcinoma (HCC), TGF-beta 1 and AFP were determined in 94 patients with cirrhotic HCC and in 94 sex- and age-matched patient s with cirrhosis alone. TGF-beta 1 and AFP levels in HCC were higher t han in cirrhosis alone (P = 0.0001). There is an inverse correlation b etween TGF-beta 1 and log AFP (r = -0.292, P = 0.004). Multivariate an alysis indicated that TGF-beta 1 and AFP were closely associated, in a dose-related fashion, with the development of HCC. Receiver-operating characteristic (ROC) curves were used to determine the optimal cutoff values of TGF-beta 1 (50 mu g g(-1) creatinine) and AFP (100 ng ml(-1 )). Both TGF-beta 1 and AFP showed a high specificity (99%) and positi ve likelihood ratio. The sensitivity was 53.1% for TGF-beta 1 and 55.3 % for AFP. The determination of both markers in parallel significantly increased the diagnostic accuracy (90.1%) and sensitivity (84%), with a high specificity (98%) and positive likelihood ratio (40.0). In con clusion, TGF-beta 1 and AFP are independent tumour markers of HCC and may be used as complementary tumour markers to discriminate HCC from c irrhosis.