Altered dynamics of alpha-fetoprotein production following pyridoxine and adenosine 5'-triphosphate administration to cirrhotic patients with or without primary hepatomas and to liver-injured and hepatoma-bearing rats.

In 12 cirrhotic patients who developed primary hepatocellular carcinomas during long-term follow-up, surveillance by frequent serum alpha-fetoprotein (AFP) measurements was not useful for their earlier detection. Difficulty was encountered in deciding whether or not hepatomas had already developed in cirrhotic patients with serum AFP levels over 200 ng/ml. Simultaneous injections of pyridoxine and adenosine 5'-triphosphate (ATP) resulted insignificant decreases of elevated serum AFP levels in carbon tetrachloride (CCl4)-injured rats but in 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB)-induced hepatoma-bearing rats. On clinical application of this procedure, it was found that cirrhotic patients without hepatomas could be differentiated from those with primary hepatomas since in the former a clear reduction of AFP levels following the administration of pyridoxine and ATP took place. This may be a new approach to the earlier diagnosis of primary hepatomas in cirrhotic patients with elevated serum AFP levels.