A Clear Solution for Dirty Water

Serum levels of alpha1-antitrypsin (alAT) were measured by radial immunodiffusion and phenotypes were determined by electrofocusing in acrylamide gel in 39 patients with hepatocellular carcinoma (HCC) positive for serum hepatitis B surface antigen (HBsAg), 41 patients with HCC negative for serum HBsAg, and 160 ageand sex-matched hospital controls. There was no difference between the control series and either of the two HCC groups with respect to a,AT phenotype pattern; also, there was no evidence of association between HCC and either the M2 allele or any of the alAT deficiency phenotypes. However, HCC cases negative for HBsAg had significantly higher serum cx1AT values (mean 665 +26mg 100ml1) than HCC cases positive for HBsAg (mean 571+23mglOOml1), who in turn, had significantly higher alAT values than hospital controls (mean 434+13mg 100 ml 1). These results indicate that (i) in Greece, as in other high HCC incidence countries, genetically determined alAT deficiency is not aetiologically important; (ii) the increase of serum c,AT is an important correlate of HCC with possible aetiologic significance and diagnostic potential and (iii) HBsAg-positive HCC and HBsAg-negative HCC are manifest differently as well as being aetiologically distinct.