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Determination of Plasma Urokinase-type Plasminogen Activator Antigen in Patients with Primary Liver Cancer: Characterization as Tumor-associated Antigen and Comparison with -Fetoprotein¹

Laboratory for Clinical Experimental Physiology [K. H., J. C. K., C. B., B. R. B.] and the Second Department of Gastroenterology and Hepatology [K. H., D. E], University of Vienna, Austria

We determined the plasma levels of urokinase-type plasminogen activator (u-PA) antigen and -fetoprotein (AFP) in 44 patients with different 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 detecting primary liver cancer were 57 and 62%, respectively, and specificity values were 95 and 86%, respectively. A combination of both markers led to a significant increase of sensitivity to 89.7%. The specificity of the combination of both markers was 97.3%. In tumor patients with unilocular disease and tumor patients with multicentric disease and/or metastatic spread, similar sensitivity values could be obtained with both markers. Therefore, a combination of u-PA and AFP can increase the accuracy of detection of primary liver cancer, especially in chronic liver diseases known to be predisposing for primary liver cancer, e.g., liver cirrhosis of long duration.

¹ Supported by grants from the Austrian Federal Bank (P2330) and the Austrian Funds for the Promotion of Scientific Research (P6832 and P8011).

² To whom requests for reprints should be addressed, at Laboratory for Clin. Exp. Physiology, University of Vienna, Schwarzspanierstr. 17, A-1090 Vienna, Austria.

Received 9/ 5/91. Accepted 1/17/92.