title: Fucosylated fraction of alpha-fetoprotein, L3, as a useful prognostic factor in patients with hepatocellular carcinoma with special reference to low concentrations of serum alpha-fetoprotein.
abstract: BACKGROUND
  The aim of the present study was to establish L3 fraction before initial treatment as a useful prognostic factor in a prospective fashion in hepatocellular carcinoma (HCC) where the alpha-fetoprotein (AFP) was very low.
  
  
  METHODS
  From 1990 to 2004, 298 HCC patients in whom L3 could be measured were examined in the present study. Enrolled patients with HCC underwent operation, transcatheter arterial chemoembolization and percutaneous ablation therapy. The current patient status was confirmed as of the end of March 2005. L3 was determined by crossed immuno-affinoelectrophoresis when AFP was >/=30 ng/mL. It was carried out by liquid-phase binding assay system on cases where AFP < 30 ng/mL. The tentative discriminating line of L3 was set at 15%.
  
  
  RESULTS
  The HCC group included four subgroups: 110 patients with AFP concentrations </=100 ng/mL, 70 with AFP</= 50 ng/mL, 38 with AFP </= 30 ng/mL and 29 with AFP </= 25 ng/mL. The mean survival rate in the HCC group, whose L3 was >15% (high L3), was significantly lower than that in the HCC group whose L3 was </=15% (low L3). There were also statistically significant differences in survival rates between high and low L3 in the four HCC subgroups. The statistically significant differences were more distinct in the subgroups with low AFP concentrations.
  
  
  CONCLUSIONS
  The present study indicates that the L3 fraction before treatment serves as a useful prognostic indicator when the serum concentrations of AFP were very low.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Cellular Function, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kuroiwa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tamura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kawai
authors.forename: Masato
authors.initials: M
authors.lastname: Igarashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Fukuhara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aoyagi