Serum C-reactive protein as a serum marker for the diagnosis of hepatocellular carcinoma.

An abnormal serum C-reactive protein (CRP) level (greater than 10 mg/l) was found in 78% of 104 patients with hepatocellular carcinoma (HCC), 8% of 12 asymptomatic hepatitis B surface antigen carriers, 5% of 77 patients with chronic hepatitis, and 9% of 55 cirrhotic patients without complications. It was also discovered in 72% of 25 cirrhotic patients complicated with bacterial infections, gastrointestinal bleeding, hepatic encephalopathy, or massive ascites, 67% of nine common bile duct stone patients, and 79% of 14 patients with malignancies other than HCC. A dramatic decrease in serum CRP levels was found in two HCC patients receiving a successful surgical tumor resection, four cirrhotic patients recovering from complications, and all six patients with common bile duct stones and cholangitis controlled by antibiotics, but not in untreated HCC or other malignancy patients. Serum alpha-fetoprotein (AFP) levels correlated poorly with CRP levels. A combination of these two serum markers identified 94% of 104 patients with HCC. Since serum CRP levels were also abnormal in 57% of 14 patients with resectable HCC (less than or equal to 5 cm), in conjunction with AFP, it may be useful in the diagnosis of HCC or other malignancies.