1st-order laboratory parameters-obligatory laboratory tests.
- Small blood count
- Differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin.
- Tumor markers
- Α-Fetoprotein (AFP)* – specific tumor marker in hepatocellular carcinoma [> 200-300 μg/l; a negative AFP does not rule out hepatocellular carcinoma!; sensitivity (percentage of diseased patients in whom the disease is detected by use of the test, ie. i.e., a positive test result occurs) is reported to be 41-65%, depending on the study and the cut-off value chosen; specificity (probability that actually healthy individuals who do not have the disease in question are also detected as healthy by the test) is reported to be 80-94%]
- DCP (des-gamma-carboxyprothrombin) – tumor marker in hepatocellular carcinoma.
- CEA (carcino-embryonic antigen) and CA 19-9, CA 72-4.
- Coagulation parameters – Quick, PTT (partial thromboplastin time).
- Albumin
- AMA (antimitochondrial antibodies)
- Ferritin
- PIVKA-2 (Prothrombins induced by Vitamins K Absence) – laboratory parameter formed in the liver in the absence of vitamin K.
- Vitamin B12
- Hepatitis A, B and C serology
- Punch biopsy from the tumor and liver tissue (liver puncture (liver biopsy)), percutaneous (through the skin) sonographic or CT-guided.
* Specialty societies recommend AFP determination and sonography every six months in patients with liver cirrhosis as screening for hepatocellular carcinoma.
