title: Lens culinaris agglutinin-reactive α-fetoprotein decline after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma predicts survival.
abstract: BACKGROUND
  Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3) is a fucosylated fraction of AFP that is highly specific for hepatocellular carcinoma (HCC). We studied the relationship between AFP-L3 response and treatment outcome in terms of radiologic response and overall survival in patients undergoing transcatheter arterial chemoembolization (TACE).
  
  
  METHODS
  We retrospectively analyzed 152 patients with advanced HCC undergoing TACE. Serum AFP-L3 and AFP levels were measured simultaneously with a novel lectin dual-label time-resolved immunofluorometric assay (lectin dual-label TRFIA). AFP-L3 response was defined as a ≥20% reduction in AFP-L3 level after a minimum of 2 cycles of chemotherapy.
  
  
  RESULTS
  A total of 47 AFP-L3 responders had improved median overall survival of 42.9 months compared with 15.4 months in nonresponders (P<0.0001), and AFP-L3 response was strongly associated with radiologic response (P<0.0001). The combination of AFP-L3 response and serum AFP response provided further prognostic information. On multivariate analysis, the prognostic value of AFP-L3 response was independent of maximum tumor diameter and BCLC stage.
  
  
  CONCLUSIONS
  A significant reduction in AFP-L3 in patients with advanced HCC is an important predictor of survival. Achieving an AFP-L3 response should be one of the therapeutic intents of TACE.
authors.affiliation: Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200025, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200025, China.
authors.forename: Shile
authors.initials: S
authors.lastname: Sheng
authors.affiliation: Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200025, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200025, China.
authors.forename: Jianju
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200025, China. Electronic address: huanggang2802@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D015200:Fluoroimmunoassay / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D037121:Plant Lectins / Q000737:chemistry*; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000737:chemistry*
chemical_list: D037121:Plant Lectins; D000509:alpha-Fetoproteins; C033619:lentil lectin
keywords: Hepatocellular carcinoma; Lens culinaris agglutinin-reactive α-fetoprotein; Radiologic imaging; Time-resolved immunofluorometric assay; Transcatheter arterial chemoembolization