Relationship between Lens culinaris agglutinin-reactive alpha-fetoprotein and pathologic features of hepatocellular carcinoma.
OBJECTIVE
We investigated pathological features of Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3)-positive hepatocellular carcinoma (HCC) in order to seek a pathological basis of poor prognosis of HCC patients with elevated AFP-L3.


METHODS
A total of 111 patients with HCC < or =5 cm in diameter who underwent hepatic resection were studied. Serum AFP-L3 concentration was measured within a month prior to surgery by lectin-affinity electrophoresis coupled with antibody-affinity blotting, and expressed as AFP-L3 percentage of total AFP. AFP-L3 of 10% or higher was judged to be positive. Pathologic features of resected HCC specimens were evaluated and classified concerning growth pattern (expansive or infiltrative growth), capsule formation, capsule infiltration, septal formation, portal vein invasion, hepatic vein invasion, bile duct invasion, and intrahepatic metastasis. These macroscopic and microscopic findings were compared between AFP-L3-positive and negative HCC specimens.


RESULTS
Thirty-three (29.7%) were positive for AFP-L3. The prevalence of HCC with infiltrative growth, with capsule infiltration, with septum formation, with portal vein invasion, and with hepatic vein invasion was significantly higher in AFP-L3-positive group (P=0.0121, 0.0290, 0.0442, 0.0314, and 0.0433, respectively). These pathologic features reportedly indicate the progression of the tumor.


CONCLUSIONS
AFP-L3-positive HCC had several pathologic features of progressed state of HCC, which accounted for the AFP-L3 as an indicator of poor prognosis of HCC.
Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Toshifumi
T
Tada
Takashi
T
Kumada
Hidenori
H
Toyoda
Seiki
S
Kiriyama
Yasuhiro
Y
Sone
Makoto
M
Tanikawa
Yasuhiro
Y
Hisanaga
Shusuke
S
Kitabatake
Teiji
T
Kuzuya
Koji
K
Nonogaki
Junichi
J
Shimizu
Akihiro
A
Yamaguchi
Masatoshi
M
Isogai
Yuji
Y
Kaneoka
Junji
J
Washizu
Shinji
S
Satomura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000556:secondary; D005260:Female; D022781:Hepatocytes / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D027806:Lens Plant; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D037121:Plant Lectins / Q000097:blood*; D011379:Prognosis; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis / Q000145:classification / Q000378:metabolism*
D014408:Biomarkers, Tumor; D037121:Plant Lectins; D000509:alpha-Fetoproteins; C033619:lentil lectin