The diagnostic utility of serum ferritin. Estimation in patients with primary hepatocellular carcinoma.

Serum hepatitis B surface antigen (HBsAg) status and ferritin levels were measured in 3 groups of subjects: Group A (n = 14) with chronic non-neoplastic liver disease (CNLD), Group B (n = 14) with primary hepatocellular carcinoma (PHC) and Group C (n = 14) comprising healthy matched controls without liver disease. Serum ferritin values were lowest in Group C, intermediate in Group A and highest in the Group B patients (all p < 0.05). About 79% of the patients with PHC, 43% of those with CNLD and none (0%) of the healthy controls, had hyperferritinaemia (serum ferritin > 400 ng/ml). Hyperferritinaemia and HBsAg positivity coexisted in 15% and 73% of the patients with CNLD and PHC, respectively. Hyperferritinaemia and HBsAg were significantly positively related in the patients with PHC (chi 2 5.09, p < 0.05). The predictive indices of hyperferritinaemia in chronic liver disease appeared superior for PHC than for CNLD, and became somewhat enhanced with coexisting HBsAg positivity. These results suggest that serum ferritin could be useful as a tumour marker for PHC in patients with established chronic liver disease.