Abstract: In 226 cases of various digestive diseases including 30 benign cases, 170 malignant cases and 26 recurrent cases, we determined the serum ferritin values by using antiplacental ferritin antiserum to provoke reversed passive hemagglutination and we studied the utility and limitations of the method. We also investigated to what extent a combinaion assay for serum ferritin and blood carcinoembryonic antigen (CEA) or serum ferritin and serum alpha fetoprotein would increase the rate of cancer diagnosis. The frequency of abnormal serum ferritin values was 10% in the benign cases and 7.8%, 15.6% and 28.6%, respectively, in cases of primary gastric, colorectal and esophageal cancer. Thus, there was no significant difference between the benign and the malignant cases. However, in the cases of recurrent gastric and colorectal cancer, the rates were 44.4% and 55.8%, respectively, exhibiting a significantly higher rate than in the primary cases. In pancreatic cancer and primary hepatoma the rates were 50% and 66.7%, respectively, so that primary hepatoma exhibited a significantly higher rate than the benign cases. Furthermore, abnormal values of either or both of the serum ferritin and blood CEA were significantly more frequently observed in primary cases of colorectal, esophageal, and pancreatic cancer and primary hepatoma than in the benign diseases. These rates were significantly higher in cases of recurrent gastric and colorectal cancer than in primary cases of these cancers. In primary hepatoma, the incidence of abnormality was higher in the combination assay for serum ferritin and serum alpha-fetoprotein than in the assay for serum ferritin alone. Thus, it is thought that the combination assay for ferritin and CEA or ferritin and alpha-fetoprotein is useful for the supplementary diagnosis of cancer. However, since the serum ferritin also rises in such benign diseases as hepatitis and liver cirrhosis, it is advisable to be somewhat cautious in evaluating such a rise.
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