The low positive rate of serum alpha-fetoprotein levels in hepatitis C virus antibody-positive patients with hepatocellular carcinoma.

We analyzed the clinicopathological factors influencing the serum AFP levels at the time of diagnosis in 114 patients with resected HCC. The proportion of HCC patients with high serum AFP levels (> 100 ng/ml) has been steadily decreasing from a rate of 57.2% in 1980 to 33.3% in 1993. A significant relationship was noted between the serum AFP levels and the virus marker (p < 0.01) based on a multivariate analysis. The proportion of HCC patients with high serum AFP levels was significantly less in anti-HCV- positive HCC patients than in HBsAg-positive HCC patients (p < 0.01). The proportion of HBsAg-positive HCC patients has been steadily decreasing from a rate of 48% in 1980 to 15% in 1993. In contrast, the proportion of anti-HCV-positive HCC patients was 69% in 1993. It is thus assumed that the prevalence of anti-HCV-positive HCC patients is increasing recently, based on the fact that the incidence of HCC patients with high serum AFP levels is decreasing.