title: Lectin-reactive alpha-fetoprotein (AFP-L3%) curability and prediction of clinical course after treatment of non-seminomatous germ cell tumors.
abstract: OBJECTIVE
  Alpha-fetoprotein (AFP) is an important tumor marker for non-seminomatous germ cell tumors (NSGCTs) that greatly affects diagnosis and the evaluations of therapy and therapeutic policy. However, it is sometimes very difficult to make the distinction between tumors and falsely elevated AFP levels due to benign liver disease. We assessed the usefulness of lectin-reactive alpha-fetoprotein (AFP-L3%), which has been reported to be superior to total AFP in both sensitivity and specificity in hepatocellular carcinomas, for the evaluation of predictions of clinical courses after the treatment of NSGCTs.
  
  
  METHODS
  Frozen sera of 25 tumor-bearing patients with testicular cancers whose AFP levels were 5.0 ng/ml or higher were used. The total AFP levels and the ratio of L3 fraction to total AFP (AFP-L3%) were measured by liquid-phase binding assay (LBA).
  
  
  RESULTS
  The total AFP levels were 6.3-14 907 ng/ml (median: 105.9 ng/ml). The median AFP-L3% was 69.9% (range;: 1.1-88.1%). Except for one patient, 24 patients (96.0%) with evident disease showed high levels of AFP-L3% of >50%, regardless of their total AFP levels. In nine patients whose sera were sequentially measured, AFP-L3% was considered highly useful for the detection of residual tumors (n = 2) and recurrence (n = 1) and for the exclusion of false-positive cases (n = 1).
  
  
  CONCLUSIONS
  When the total AFP level increases slightly (e.g. to 5-20 ng/ml), a measurement of AFP-L3% may provide additional useful information for monitoring NSGCT patients and in distinguishing falsely elevated AFP.
authors.affiliation: Department of Urology, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Satomura
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Yoshiki
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Okada
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Henmi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D003937:Diagnosis, Differential; D018240:Endodermal Sinus Tumor / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D037102:Lectins; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000601:surgery; D009919:Orchiectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D037102:Lectins; D000509:alpha-Fetoproteins