Is liver function test of any diagnostic relevance in patients presenting with hepatocellular carcinoma?

Abstract

Background: Hepatocellular carcinoma (HCC) is a tumor with very poor prognosis in Nigeria because of late diagnosis. This underscores the need for cheap and available investigations to aid early diagnosis. Liver function test (LFT) is affordable, available and minimally invasive. The recognition of specific fluctuations in liver function test in HCC will facilitate pragmatic clinical, radiological and histopathological evaluation in individuals at risk.
Aim / Objective: To determine if specific fluctuations in LFT is suggestive of HCC in patients presenting with this tumor at a tertiary health center in South-East Nigeria.
Methods: This was a case-control study. Sera from 64 patients with HCC and 120 patients without HCC were analyzed for bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and albumin.
Results: A total of 184 patients were studied. Among the patients with HCC, AST and ALT were elevated in 30(46.9%) and 31(48.4%) patients, respectively, while ALP was elevated in 33(52%). Hyperbilirubinaemia was present in 34(53%) and hypoalbuminaemia in 54(84.3%) of the patients. Except for bilirubin, LFT was more frequently abnormal in HCC than in non-HCC cases. However, the difference was not statistically significant between HCC and liver cirrhosis (p >0.05).
Conclusion: No specific pattern of LFT is diagnostic of HCC. Abnormal LFT in a high risk patient should prompt urgent imaging and histopathological evaluation.

Keywords: Hepatocellular carcinoma, Liver function test