A 61-year-old man with a history of chronic viral hepatitis has noted a 6-kg weight loss over the past 5 months. Physical examination shows no masses or palpable lymphadenopathy. An abdominal CT scan shows a nodular liver with a 10-cm mass in the right lobe. A stool guaiac test result is negative. An elevation in which of the following laboratory tests is most likely to be present in this man?
Some chronic hepatitis B and C viral infections progress to hepatocellular and/or cholangiolar carcinoma. a-Fetoprotein (AFP) is an oncofetal protein that is a tumor marker for hepatocellular carcinomas and some testicular carcinomas. AFP is normally present in fetal life but not in adults. A serum immunoglobulin level with protein electrophoresis aids in the diagnosis of myeloma. Gastrointestinal tract adenocarcinomas, including those arising in the stomach, colon, and pancreas, as well as some lung carcinomas, may be accompanied by elevations in the serum carcinoembryonic antigen level. CA-19-9 is a tumor marker for colonic and pancreatic carcinomas. Some thyroid carcinomas produce calcitonin. Unfortunately, the sensitivity and specificity of tumor marker tests for the detection of cancers, when they are small, is not high.
Alpha-fetoprotein
CA-19-9
Calcitonin
Carcinoembryonic antigen
Neoplasia