62 patients with histologically proven hepatocellular carcinoma have been investigated for the presence of serological markers of hepatitis B virus infection, and the findings have been related to alpha 1-fetoprotein measurements and to the nature of the basic disease process affecting the liver. The results document a statistically significant increase in the prevalence of hepatitis B virus markers as compared to patients with cirrhosis of the liver only, pointing to a probable etiological relationship between hepatitis B virus infection and hepatocellular carcinoma even in areas of the world where the infection is not endemic. Early detection of hepatocellular carcinoma is limited by the remarkably high percentage of patients who have no, or only marginal, elevation of serum alpha 1-fetoprotein.
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