title: Highly sensitive lens culinaris agglutinin-reactive α-fetoprotein is useful for early detection of hepatocellular carcinoma in patients with chronic liver disease.
abstract: The fucosylated fraction of α-fetoprotein (AFP-L3) is a specific marker for hepatocellular carcinoma (HCC). However, conventional AFP-L3% (c-AFP-L3%) has not always been reliable in cases with low serum α-fetoprotein (AFP) levels. In this study, we evaluated the clinical utility of a newly developed assay, highly sensitive AFP-L3% (hs-AFP-L3%). Subjects included 74 patients with benign liver disease (BLD), including chronic hepatitis and cirrhosis, and 94 with HCC. Serum hs-AFP-L3% was significantly higher than c-AFP-L3% in patients with early-stage HCC (solitary or <20 mm in diameter). Additionally, hs-AFP-L3% was significantly increased in patients with well-differentiated HCC. In patients with serum AFP <20 ng/ml, the sensitivities of c-AFP-L3% and hs-AFP-L3% were 12.5 and 44.6%, respectively, at a cut-off value of 5%. In 59 BLD patients with serum AFP <20 ng/ml, the HCC-positive rate in patients with hs-AFP-L3% ≥ 5% was significantly higher compared to those with hs-AFP-L3% <5% during the follow-up period (median, 35 months; range, 5-48 months). Importantly, none of the BLD patients with both serum AFP <20 ng/ml and hs-AFP-L3% <5% developed HCC. These results indicated that hs-AFP-L3% is useful for early detection of HCC in BLD patients, even for those with serum AFP <20 ng/ml. Furthermore, since hs-AFP-L3% increases before HCC is detectable by various advanced imaging modalities, this assay may help identify BLD patients with a higher risk of HCC.
authors.affiliation: Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Oda
authors.forename: Akio
authors.initials: A
authors.lastname: Ido
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tamai
authors.forename: Masakaze
authors.initials: M
authors.lastname: Matsushita
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kumagai
authors.forename: Sei-ichi
authors.initials: S
authors.lastname: Mawatari
authors.forename: Akiko
authors.initials: A
authors.lastname: Saishoji
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kure
authors.forename: Kaori
authors.initials: K
authors.lastname: Ohno
authors.forename: Eriko
authors.initials: E
authors.lastname: Toyokura
authors.forename: Dai
authors.initials: D
authors.lastname: Imanaka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Moriuchi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Uto
authors.forename: Makoto
authors.initials: M
authors.lastname: Oketani
authors.forename: Teruto
authors.initials: T
authors.lastname: Hashiguchi
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037121:Plant Lectins / Q000737:chemistry*; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis* / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D037121:Plant Lectins; D000509:alpha-Fetoproteins; C033619:lentil lectin