title: Lens culinaris agglutinin-reactive alpha-fetoprotein as a prognostic marker in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.
abstract: Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3) is known to be a useful marker for the diagnosis of hepatocellular carcinoma (HCC). Recent studies have shown that positive AFP-L3 results after treatment predicts tumor recurrence and poor clinical outcome. This study was to evaluate the role of pretreatment AFP-L3 as a prognostic marker for response to transcatheter arterial chemoembolization (TACE) and survival in patients with HCC. Forty-six patients with HCC who underwent TACE were analyzed. Agglutinin-reactive AFP was measured by lectin-affinity electrophoresis coupled with antibody-affinity blotting. Agglutinin-reactive AFP results larger than 24.4% were considered to be positive. Agglutinin-reactive AFP fractions were positive in 32 patients. Agglutinin-reactive AFP-positive patients had poorer performance status, larger tumors, frequent portal vein thrombosis, and higher levels of serum AFP. The partial response rate to TACE was lower in AFP-L3-positive patients than in AFP-L3-negative ones (37.5% vs. 78.6%, p = 0.01). Tumor size and AFP-L3 were two independent predictive factors for response to TACE. The 2-year survival rate was lower in AFP-L3-positive patients than in AFP-L3-negative ones (21.2% vs. 78.6%, p = 0.01). Child-Pugh class, AFP-L3, the presence of portal vein thrombosis, and response to TACE were independent prognostic factors for survival. In conclusion, pretreatment status of AFP-L3 could be considered a useful marker for predicting clinical outcome in patients with HCC who underwent TACE.
authors.affiliation: Department of Internal Medicine, Cheju National University College of Medicine, Cheju National University Hospital, Korea.
authors.forename: Byung-Cheol
authors.initials: BC
authors.lastname: Song
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Suh
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Yang
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
authors.forename: Young-Hwa
authors.initials: YH
authors.lastname: Chung
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Yung Sang
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D027806:Lens Plant; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D037121:Plant Lectins / Q000097:blood*; D011379:Prognosis; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D037121:Plant Lectins; D000509:alpha-Fetoproteins; C033619:lentil lectin