title: Highly sensitive AFP-L3% assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre- and postoperatively.
abstract: OBJECTIVE
  The micro-total analysis system (µTAS), a fully automated immunoassay system using microchip capillary electrophoresis, is highly sensitive and able to quickly assay the AFP-L3%. The clinical usefulness of this system was studied.
  
  
  METHODS
  We retrospectively enrolled 250 patients who underwent curative treatment for primary hepatocellular carcinoma (HCC) (93 patients underwent hepatic resection and 157, radiofrequency ablation [RFA]).
  
  
  RESULTS
  The sensitivity for µTAS AFP-L3% was 40.3% at the cutoff value of 5% in a range of AFP less than 20 ng/mL where the conventional method was unable to determine AFP-L3%. The sensitivity for AFP-L3% remained high even at stage I and at tumor size less than 2 cm (42.5% and 46.0%, respectively). Recurrence rate of patients with AFP-L3% greater than 5% was significantly higher than that of patients with less than 5% (P = 0.001). Furthermore, in resected patients, the postoperative AFP-L3% remained elevated with value greater than 5% was related to HCC recurrence (P = 0.001). Multivariate analysis revealed that multiple tumors (P = 0.004), preoperative AFP-L3% greater than 5% (P = 0.003), albumin less than 3.5 g/dL (P = 0.008), and RFA (P = 0.003) were significant prognostic factors of recurrence.
  
  
  CONCLUSIONS
  The µTAS was found to be a highly sensitive assay for AFP-L3% in patients with curative treatment of HCC. A cutoff value of 5% was useful for predicting recurrence after the curative treatment and detecting small tumors and early stage HCC. Additionally, postoperative AFP-L3% was found to be a prognostic factor of HCC recurrence.
authors: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors: Masahiro
authors: M
authors: Kobayashi
authors: Tetsuya
authors: T
authors: Hosaka
authors: Kenji
authors: K
authors: Ikeda
authors: Yuya
authors: Y
authors: Seko
authors: Yusuke
authors: Y
authors: Kawamura
authors: Hitomi
authors: H
authors: Sezaki
authors: Norio
authors: N
authors: Akuta
authors: Fumitaka
authors: F
authors: Suzuki
authors: Yoshiyuki
authors: Y
authors: Suzuki
authors: Satoshi
authors: S
authors: Saitoh
authors: Yasuji
authors: Y
authors: Arase
authors: Hiromitsu
authors: H
authors: Kumada