The value of serum concentrations of tissue polypeptide antigen in the diagnosis of hepatocellular carcinoma.

Tissue polypeptide antigen (TPA) is a polypeptide isolated from malignant cells and found in high concentration in the serum of patients with various tumors. No information is available with respect to hepatocellular carcinoma (HCC). Serum TPA concentrations were measured in 290 patients with HCC, 85 healthy controls, 33 patients with amebic hepatic abscesses, 43 with chronic hepatitis or cirrhosis, and 39 with acute hepatitis. Raised values were found in 96% of the HCC patients, but also in 61% of patients with amebic abscesses, 86% with chronic hepatic parenchymal disease, and 90% with acute hepatitis. If a cut-off level of 500 IU/L was used, this reduced the sensitivity of TPA in HCC to 46%, but still left 46% of patients with acute hepatitis with raised values. TPA is comparable in sensitivity with alpha-fetoprotein as a marker for HCC, but its lack of specificity severely limits its clinical usefulness.