Background/aims: Tissue polypeptide specific antigen was first defined by Bjorklund in 1957 and is the specific M3 epitope of tissue polypeptide antigen. It is increased in malignant as well as in some benign diseases. The level of tissue polypeptide specific antigen in serum is related mostly with proliferation capacity rather than with tumor mass and cell necrosis. The aim of this study was to evaluate the levels of tissue polypeptide specific antigen and other tumor markers in patients with liver cirrhosis, chronic active hepatitis and hepatoma to determine if tissue polypeptide specific antigen is superior to other tumor markers in hepatoma patients. Methods: Thirty-seven patients and 20 controls were included in the study. The patients were divided into three subgroups as cirrhosis, hepatoma and chronic active hepatitis. The levels of tissue polypeptide specific antigen, carcinoembryonic antigen, CA19-9, alpha-fetoprotein and transaminases were determined in all patients. Results: Tissue polypeptide specific antigen levels were significantly higher in all patients than in the control group (p<0.005) According to Kruskal-Wallis test with regard to subgroups, the differences in mean values of tissue polypeptide specific antigen and alpha-fetoprotein were highly significant (p: 0.0001 for both). There was a low correlation between tissue polypeptide specific antigen and alpha-fetoprotein in the cirrhotic and hepatoma groups, but these were significantly correlated in the chronic active hepatitis group. The correlation coefficient between tissue polypeptide specific antigen and transaminases in all patients was low. Conclusions: Our data suggest that tissue polypeptide specific antigen is efficient in determining primary hepatoma patients and also that this marker is specific for proliferation of cells.