Serum AFP is the most widely studied screening test for detecting HCC. The normal range for serum AFP levels is 10-20 ng/mL and a level > 400 ng/mL is usually regarded as diagnostic.
You might also have a blood test to look at the level of a chemical called alpha fetoprotein (AFP). This might be higher than normal in some types of liver cancer. This might help to diagnose a possible cancer or other conditions. You have blood tests in combination with other tests.
Elevated levels of the two enzymes, which are involved in producing amino acids, are an indicator of liver damage. The scientists found that levels of ALT or AST at or above 25 international units per liter of blood were predictive of cancer risk.
Interestingly, the baseline AST/ALT ratio of individuals developing cancers (median: 1.23, IQR: 0.96–1.54) was significantly greater than that of patients diagnosed with cancer (median: 1.11, IQR: 0.91–1.44) and individuals without cancer (median: 1.15, IQR: 0.91–1.44).
Alpha-fetoprotein tumor marker
Alpha-fetoprotein (AFP) is the most widely used tumor marker for detecting liver cancer. However, other cancers and certain conditions, including pregnancy, hepatitis, and other types of cancer, may also increase AFP levels.
The proportion of liver enzyme elevations may help indicate cancer. For example, elevations in ALT and AST without significant elevations in bilirubin or ALP may suggest a problem in the cells of the liver, including potential cancer.
An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
Typically the range for normal AST is reported between 10 to 40 units per liter and ALT between 7 to 56 units per liter. Mild elevations are generally considered to be 2-3 times higher than the normal range. In some conditions, these enzymes can be severely elevated, in the 1000s range.
When liver cells are damaged, they release ALT into the bloodstream. High levels of ALT in your blood may be a sign of a liver injury or disease. Some types of liver disease cause high ALT levels before you have symptoms of the disease. So, an ALT blood test may help diagnose certain liver diseases early.
Computed tomography (CT or CAT) scan.
This dye can be injected into a patient's vein or given as a liquid to swallow. Often, HCC can be diagnosed based on features specific to the cancer that are seen on a CT scan. This helps patients avoid a liver biopsy (see below). A CT scan can be used to measure the tumor's size.
When signs and symptoms do appear, they may include unintentional weight loss, loss of appetite, upper abdominal pain, nausea and vomiting, general weakness and fatigue, abdominal swelling, jaundice where your eyes and skin turn yellow, and white, chalky stools.
Smokers may have an elevated CEA without malignant disease; smoking may affect accuracy of CEA results. Normal range: < 2.5 ng/ml. Normal range may vary somewhat depending on the brand of assay used. Levels > 10 ng/ml suggest extensive disease and levels > 20 ng/ml suggest metastatic disease.
The three most important characteristics of an ideal tumor marker are (a) it should be highly specific to a given tumor type, (b) it should provide a lead-time over clinical diagnosis and (c) it should be highly sensitive to avoid false positive results.
What ALT level is considered high? The upper limit of normal for ALT is 55 IU/L. When an ALT level is double to triple the upper limit of normal, it is considered mildly elevated. Severely elevated ALT levels found in liver disease are often 50 times the upper limit of normal.
Although levels of ALT and AST can be extremely elevated (exceeding 2,000 U per L in cases of hepatocyte injury and necrosis related to drugs, toxins, ischemia, and hepatitis), elevations less than five times the upper limit of normal (i.e., about 250 U per L and below) are much more common in primary care medicine.
Moderate increase in ALT (such as 70 U/L) is seen in chronic hepatitis, chronic obstruction of bile ducts, heart damage, alcohol abuse, liver tumor, skeletal muscle damage.
Most liver diseases are associated with greater elevation of ALT than AST because of the longer circulating half-life of ALT. Exceptions include alcoholic hepatitis, cirrhosis, Wilson disease and very early liver damage.
Your ALT level is considered high if it exceeds the normal range of 0 to 44 IU/L. Some laboratories may present a slightly different reference interval, but a test result of 55 IU/L or above could indicate liver problems.
Screening options for liver cancer include testing the blood for a substance called alpha-fetoprotein (AFP), which may be produced by cancer cells, or having imaging tests like an ultrasound, computed tomography (CT or CAT) scan, or magnetic resonance imaging (MRI).
Taking steps to lower ALT levels can help the liver recover. Lifestyle changes, such as a healthful diet and regular exercise, can all help to lower ALT levels. This article looks at eight ways people can try to reduce their ALT levels. It also discusses the ideal levels and how to measure them.
Other causes of elevated liver enzymes include: Alpha-1 antitrypsin deficiency. Cancer. Celiac disease.