Clinical significance of lens culinaris agglutinin-A reactive AFP for differential diagnosis of hepatocellular carcinoma and liver cirrhosis / 대한내과학회지

AFP has been the most useful tumor marker of hepatocellular carcinoma (HCC) because AFP is tumor specific and organ specific. However it can be elevated in liver cirrhosis (LC) and chronic hepatitis as well. AFP in hepatocellular carcinoma has been known to be highly reactive Lens Culinaris Agglutinin-A (LCA-A). The aim of our study is to find whether LCA-A reactive AFP (AFP-L3) is useful in differentiation of HCC and LC with high serum AFP level (>20 ng/ml). METHODS: The material consists of sera from 18 patients with HCC and 16 patients with LC whose serum AFP concentration was above 20 ng/ml. Sera were tested for AFP-L3 by lectin-affinity electrophoresis, coupled with antibody affinity blotting with alpha-fetoprotein differentiation kit L (Wako Pure Chemical Industries, Osaka, Japan). AFP-L3 fraction percentage was checked by densitometry (580nm, Cliniscan II, Helena). RESULTS: AFP-L3 detection rate in membrane was 61.1% in HCC and 37.5% in LC. When cut-off value level is 15%, the positive rate was 61.1% in HCC and 31.2% in LC, and sensitivity and specificity of AFP-L3 fraction in HCC was 61.1% and 68.8% respectively. In according to these results, AFP-L3 was a useful marker in differentiation HCC and LC with high serum AFP level. There was no significant relation in AFP-L3 fraction and tumor size, but there was significant relation between AFP-L3 fraction and total AFP serum level(P=0.049). CONCLUSION: These results lead us to conclude that the level of AFP-L3 is a useful marker in differentiation of HCC and LC with high serum AFP level.

Clinical significance of lens culinaris agglutinin-A reactive AFP for differential diagnosis of hepatocellular carcinoma and liver cirrhosis / 대한내과학회지

AFP has been the most useful tumor marker of hepatocellular carcinoma (HCC) because AFP is tumor specific and organ specific. However it can be elevated in liver cirrhosis (LC) and chronic hepatitis as well. AFP in hepatocellular carcinoma has been known to be highly reactive Lens Culinaris Agglutinin-A (LCA-A). The aim of our study is to find whether LCA-A reactive AFP (AFP-L3) is useful in differentiation of HCC and LC with high serum AFP level (>20 ng/ml). METHODS: The material consists of sera from 18 patients with HCC and 16 patients with LC whose serum AFP concentration was above 20 ng/ml. Sera were tested for AFP-L3 by lectin-affinity electrophoresis, coupled with antibody affinity blotting with alpha-fetoprotein differentiation kit L (Wako Pure Chemical Industries, Osaka, Japan). AFP-L3 fraction percentage was checked by densitometry (580nm, Cliniscan II, Helena). RESULTS: AFP-L3 detection rate in membrane was 61.1% in HCC and 37.5% in LC. When cut-off value level is 15%, the positive rate was 61.1% in HCC and 31.2% in LC, and sensitivity and specificity of AFP-L3 fraction in HCC was 61.1% and 68.8% respectively. In according to these results, AFP-L3 was a useful marker in differentiation HCC and LC with high serum AFP level. There was no significant relation in AFP-L3 fraction and tumor size, but there was significant relation between AFP-L3 fraction and total AFP serum level(P=0.049). CONCLUSION: These results lead us to conclude that the level of AFP-L3 is a useful marker in differentiation of HCC and LC with high serum AFP level.

Usefulness of Lens Culinaris Agglutinin-A Reactive Alpha-Fetoprotein for the Diagnosis of Hepatocelluar Carcinoma in Patients with Chronic Liver Disease Who Showed Significant Increment of Serum Alpha-Fetoprotein Level and No Mass Lesion in the Liver on U / 대한간학회지

BACKGROUND/AIMS: Lens culinaris agglutinin-A reactive alpha-fetoprotein (AFP L3) has been reported to be highly specific for the diagnosis of hepatocellular carcinoma (HCC). The present study was to evaluate the clinical usefulness of AFP-L3 for the diagnosis of HCC in the patients either with chronic liver disease or with HCC in complete remission who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. METHODS: A total numer of 34 patients (24 with chronic liver disease, 10 with HCC in complete remission) were enrolled, who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Serum AFP L3 levels were analysed by AFP differentiation kit L. Abdominal spiral CT or ultrasonogram was performed at 1-3 month intervals and all of the patients were followed up for more than 6 months. RESULTS: Among 24 patients with chronic liver disease, two were positive (higher than 15%) for AFP L3; however, HCC was not detected in these patients, while HCCs were detected in two of 22 patients negative for AFP L3 during followe-up. Eight of the 10 patients with HCC in complete remission were positive for AFP L3; recurrent HCCs were detected in 7 of those 8 patients as well as in the rest 2 patients negative for AFP L3 during follow-up. The overall sensitivity and specificity of AFP L3 measurement for the detection of HCC within 6 months of follow-up were 63.6% and 87.0%, respectively. The positive and negative predictive value for HCC in patients with chronic liver disease were O% and 90.9% and for recurrent HCC in HCC patients in remission were 87.5% and ON, respectively. CONCLUSION: The measurement of AFP L3 is suggested to be useful for the diagnostic strategy in patients either with chronic liver disease or hepatocellular carcinoma in complete remission, who showed progressive increment of serum AFP level and no mass lesion in liver on ultrasonogram.