Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive α-fetoprotein
Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive α-fetoprotein
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DOI：
10.1046/j.1440-1746.2001.02643.x
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发表时间：
2001-12-01
影响因子：
4.1
通讯作者：
Tanaka, M
中科院分区：
文献类型：
--
作者：
Oka, H;Saito, A;Tanaka, M
背景和目的：与常规血清AFP浓度相比，透镜甲胎蛋白凝集素反应部分（AFP-L3）已被报道为肝细胞癌（HCC）的高度有用的标志物，与使用其他成像方式相比，其允许早期检测HCC并预测治疗后的预后。一项涉及日本9家医院的前瞻性研究分析了HCC患者的肿瘤特征与初始检测时AFP-L3/AFP总百分比之间的关系。方法：在1996年10月1日至1997年9月30日期间，共登记了388例新诊断的HCC患者。AFP-L3百分比的临界水平从15%改变为10%。AFP-L3阳性HCC患者表现出具有晚期肿瘤的特征，如肿瘤数量、最大直径、肿瘤扩散、门静脉侵犯、肿瘤分期和肿瘤分类。以AFP-L3阳性率15%为界值，其恶性特征较10%为界值更为明确。结论：血清AFP浓度并不能反映HCC的恶性程度，但AFP-L3阳性HCC具有一定的生物学恶性特征，尤其是门静脉侵犯和肿瘤分级较低，无论肿瘤大小和血清AFP浓度是否较低，均为晚期肿瘤。由于AFP-L3具有肿瘤的特征性，因此它的存在可能是决定患者治疗和预后的重要因素。(C)2001 Blackwell Science Asia Pty Ltd.
Background and Aim: The Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) has been reported to be a highly useful marker for hepatocellular carcinoma (HCC) compared with a conventional serum AFP concentration, which allows earlier detection of HCC compared with using other imaging modalities and predicting prognosis after therapy. A collaborative prospective study involving nine Japanese hospitals was conducted to analyze the relationships between the tumor characteristics of a HCC patient and the percentage of AFP-L3/AFP total at the initial detection.Methods: Between 1 October 1996 and 30 September 1997, a total of 388 patients with newly diagnosed HCC were registered.Results: The cut-off level of the percentage of AFP-L3 was altered from 15 to 10%. The AFP-L3-positive HCC patients demonstrated the characteristics of having an advanced tumor, such as the number of tumors, maximum diameter, tumor spread, portal vein invasion, tumor stage, and tumor classification. With the conventional cut-off level of 15% of the percentage of AFP-L3, the malignant characteristics were more definite than that of 10%. However, no significant differences of serum AFP concentration were observed for malignant characteristics such as maximum diameter and histopathological grading.Conclusion: Serum AFP concentration does not reveal a malignancy of HCC, however, the AFP-L3-positive HCC has biologically malignant characteristics, especially portal vein invasion and lower tumor classification, and is an advanced tumor regardless of small tumor size and lower serum AFP concentration. As AFP-L3 shows the tumor characteristics, its presence should be an important factor in the determination of therapy and prognosis of patients. (C) 2001 Blackwell Science Asia Pty Ltd.