Diagnostic clues for recurrent hepatocellular carcinoma: comparison of tumour markers and imaging studies.
OBJECTIVE
To elucidate the usefulness of monitoring Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3) and des-gamma-carboxy prothrombin detected with a revised kit (DCP-R) as clues to the diagnosis of recurrent hepatocellular carcinoma (HCC).


METHODS
A total of 57 patients with HCC were enrolled in the study. They were classified into two groups: group A comprised 27 patients in whom the diagnostic clue to recurrent HCC appeared before November 1997; these patients were monitored by ultrasonography, computed tomography (CT), AFP and des-gamma-carboxy prothrombin detected with a conventional kit (DCP-C). Group B comprised 30 patients in whom the diagnostic clue to recurrent HCC was detected after November 1997; these patients were monitored by ultrasound, CT, AFP, AFP-L3 and DCP-R.


RESULTS
In group A, 22 and five HCC recurrences were recognized initially by imaging studies and tumour markers, respectively. In group B, 17 and 13 HCC recurrences were recognized initially by imaging studies and tumour markers, respectively. The number of patients in whom tumour markers were the first clue to the diagnosis of recurrent HCC was significantly higher in group B than in group A.


CONCLUSIONS
Periodic examination of AFP-L3 and DCP-R may be useful for the early detection of recurrent HCC.
Ando
Eiji
E
Second Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka-ken, Japan. nyando@med.kurume.u-ac.jp
Tanaka
Masatoshi
M
Yamashita
Fumihiko
F
Kuromatsu
Ryoko
R
Takada
Akio
A
Fukumori
Kazuta
K
Yano
Yoichi
Y
Sumie
Shuji
S
Okuda
Koji
K
Kumashiro
Ryukichi
R
Sata
Michio
M
D000368:Aged; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
D015415:Biomarkers; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin