Alpha 1-antitrypsin levels and phenotypes and hepatitis B serology in liver cancer.

Serum levels of alpha 1-antitrypsin (alpha 1 AT) were measured by radial immunodiffusion and phenotypes were determined by electrofocusing in acrylamide gel in 39 patients with hepatocellular carcinoma (HCC) positive for serum hepatitis B surface antigen (HBsAg), 41 patients with HCC negative for serum HBsAg, and 160 age- and sex-matched hospital controls. There was no difference between the control series and either of the two HCC groups with respect to alpha 1 AT phenotype pattern; also, there was no evidence of association between HCC and either the M2 allele or any of the alpha 1 AT deficiency phenotypes. However, HCC cases negative for HBsAg had significantly higher serum alpha 1 AT values (mean 665 +/- 26 mg 100 ml-1) than HCC cases positive for HBsAg (mean 571 +/- 23 mg 100 ml-1), who in turn, had significantly higher alpha 1 AT values than hospital controls (mean 434 +/- 13 mg 100 ml-1). These results indicate that in Greece, as in other high HCC incidence countries, genetically determined alpha 1 AT deficiency is not aetiologically important; the increase of serum alpha 1 AT is an important correlate of HCC with possible aetiologic significance and diagnostic potential and HBsAg-positive HCC and HBsAg-negative HCC are manifest differently as well as being aetiologically distinct.