[On the alpha-fetoprotein in the diagnosis of primary liver carcinoma (author's transl)].
The existence of Alpha-Fetoprotein was investigated in sera of 544 patients with laparoscopically and/or histologically proved chronic liver diseases and cancer of the liver. The applied methods were the double-diffusion technique (micro-Ouchterlony), the counter immunelectrophoresis and the latex agglutination test. In 15 patients with primary cancer of the liver there was a positive result for Alpha-Fetoprotein with the first two methods, 73,3 and 80,67%, respectively. In other liver diseases (liver cirrhosis, chronic hepatitis, malignant tumors with liver metastases) there were only a few positive results (4,17% in patients with liver metastases of unknown origin and less than 1% for the other disease groups). In this group the latex test showed a higher frequency of positive tests for Alpha-Fetoprotein, however with a concomitant rise of positive Waaler-Rose test in 80-93%. In the case of a positive rheumatic factor the latex test will therefore demand a cautious judgement because the latex particle coated with rabbit-anti-Alpha-Fetoprotein-globulin could be agglutinated by anti-rabbit-globulin existing in human serum. A correlation between the existence of Alpha-Fetoprotein and clinical parameters or laboratory datas does not exist. Increases of Alpha-Fetoprotein shown by counter immunelectrophoresis exist in primary cancers of the liver and embryonic tumors, sometimes and only temporarely in acute viral hepatitis, in some sorts of liver cirrhosis of indian children and in the case of pathologic gestation. If these last-named diseases are excluded a positive test for Alpha-Fetoprotein by precipitation methods is highly suggestive for primary cancer of the liver. Finally, the determination of this substance has a certain value for the therapeutic control of Alpha-Fetoprotein positive malignant tumors.