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

Serum hepatitis B surface antigen (HBsAg) status and ferritin levels were measured in three groups of Nigerian subjects: Group A (n = 14) with non-neoplastic disease (CNLD); Group B (n = 14) with primary hepatocellular carcinoma (PHC); and Group C (n = 14) of healthy matched controls. 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 hyperferritinemia (serum ferritin > 400 ng/ml). Hyperferritinemia and HBsAg positivity coexisted in 15% and 73% of the patients with CNLD and PHC, respectively. Hyperferritinemia and HBsAg were significantly positively related in the patients with PHC (chi 2 5.09, p < 0.05). The predictive indices of hyperferritinemia 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 tumor marker for PHC in Nigerian patients with established chronic liver disease.