Increase of Serum aú1-Acid Glycoprotein Despite the Decline of Liver Synthetic Function in Cirrhotics with Hepatocellular Carcinoma

α,-Acid glycoprotein, an acute phase reactant synthesised by the liver, has been reported to be increased in neoplastic conditions and reduced in chronic liver disease. We measured serum aracid glycoprotein by a nephelometric method in 186 subjects (112 males, 74 females): 55 had mild chronic liver disease (chronic hepatitis and steatofibrosis), 45 cirrhosis, 38 hepatocellular carcinoma, 15 extra-hepatic malignant disease; 33 healthy subjects were used as controls. Analysis of variance demonstrated a significant variability among groups (F = 17.08, P = 0.0000). Higher concentrations of α1-acid glycoprotein were detected in malignant extra-hepatic disease than in all other groups (0.01); concentrations of α1-acid glycoprotein were higher in hepatocellular carcinoma than in cirrhosis (0.01). Multiple regression analysis by groups (dependent variable = αϊ-acid glycoprotein; group 1 = mild chronic liver disease + cirrhosis; group 2 = hepatocellular carcinoma) showed a significant correlation for both group 1 (r = 0.6264, F = 8.005, P = 0.0000) and group 2 (r = 0.8947, F = 13.643, P = 0.0000). The significant standardised regression coefficients were: cholinesterase, C-reactive protein, γ-glutamyltransferase and iron (negative) for regression upon group 1; C-reactive protein, α-antiproteinase, γ-glutamyltransferase, iron (negative) for regression upon group 2. A difference between the 2 regression equation coefficients was detected (F = 5.209, P = 0.0002). In conclusion, a raised aracid glycoprotein concentration was found in patients with malignancies, both hepatic and extra-hepatic; however, patients with hepatocellular carcinoma had a lower α1-acid glycoprotein concentration than patients with malignant extra-hepatic disease. In hepatocellular carcinoma, a good correlation existed between aracid glycoprotein and other serum indices of the acute phase response. In some patients with hepatocellular carcinoma, α1-acid glycoprotein was increased, despite the decrease of liver function. © 1993, Walter de Gruyter. All rights reserved.