In order to evaluate combined serum tumor enzyme determinations in the diagnosis of hepatocellular carcinoma (HCC)

four tumor markers including gamma-glutamyl tran- speptidase isoenzyme (r-GT-II)

alkaline phosphatese isoenzyme (ALP-I)

the ratio of the two aldolase activities

fructose-1

6-diphosphoaldolase and fructose-1-phosphoaldo-lase (FDP/FIP) and a-L-fucosidase (AFU) were concomitantly determined in 59 patients with HCC

97 patients with various liver diseases and gastrointestinal tumors. The results revealed that: (l)r-GT-II

ALP-I

FDP/FIP and AFU level were increased significantly in HCC (P<0.01); (2) The diagnostic sensitivity and specificity of these markers in HCC were r-GT-II(79.7%)>AFU(78.8%)>FDP/FIP(61%)>ALP-I(16.95%) and ALP-I(100%) >r-GT-II(92.l%)>AFU(90.9%)>FDP/FIP (88.8%)

respectively; (3) The diagnostic positivity of combination assay was 80.0% in low or negative AFP producing HCC

while 95.7% in those with elevated AFP. Our data suggested that the combination assay of serum tumor enzyme markers was valuable in the diagnosis of HCC

especially in low or negative AFP HCC patients