BACKGROUND Although alpha‐fetoprotein (AFP) is a useful serologic marker of hepatocellular carcinoma (HCC), it has been reported insufficiently sensitive in detecting small HCCs. Plasma transforming growth factor‐β1 (TGFβ1) has been reported to be elevated in HCC patients compared with liver cirrhosis patients. It has been reported that TGFβ1 mRNA was overexpressed in HCC, especially in patients with small HCC and well‐differentiated HCC compared with patients with liver cirrhosis. The current study investigated the usefulness of TGFβ1 compared with AFP in the diagnosis of small HCCs. METHODS Thirty‐eight patients with small HCC (≤ 3 cm), 31 patients with liver cirrhosis only, and 23 normal volunteers were studied. Using plasma TGFβ1 and serum AFP levels measured at the time of diagnosis, the sensitivities and specificities were calculated in the diagnosis of small HCCs. RESULTS Plasma TGFβ1 and serum AFP levels were significantly higher in patients with small HCC than in those with liver cirrhosis. In diagnosing small HCCs, the cut‐off values of plasma TGFβ1 and serum AFP were 800pg/mL and 200ng/mL, respectively, where the specificities were over 95%. At the cut‐off level of plasma TGFβ1 and serum AFP, the sensitivities were 68% and 24%, respectively. CONCLUSIONS The current results suggest that TGFβ1 may be a useful serologic marker in detecting HCCs earlier because it shows higher sensitivity than, with specificity as, AFP in the diagnosis of small HCCs. Cancer 2002;94:175–80. © 2002 American Cancer Society.

Transient elastography has limited value for detecting steatosis in asymptomatic healthy individuals, and the cutoff value for fibrosis should be reevaluated in these subjects.

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