Journal Article

High-sensitivity Lens culinaris agglutinin-reactive alpha-fetoprotein assay predicts early detection of hepatocellular carcinoma

Tada, Toshifumi, Tanikawa, Makoto, Kagebayashi, Chiaki, Toyoda, Hidenori, Tanaka, Junko, Kiriyama, Seiki, Kumada, Takashi, Kanamori, Akira, Hisanaga, Yasuhiro, Satomura, Shinji

2014

Overview

Background Prognosis of patients with hepatocellular carcinoma (HCC) remains poor because HCC is frequently diagnosed late. Therefore, regular surveillance has been recommended to detect HCC at the early stage when curative treatments can be applied. HCC biomarkers, including Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3), are widely used for surveillance in Japan. A newly developed immunoassay system measures AFP-L3 % with high sensitivity. This retrospective study aimed to evaluate clinical utility of high-sensitivity AFP-L3 (hs-AFP-L3) as a predictor of early stage HCC in surveillance at a single site. Methods Of consecutive 2830 patients in the surveillance between 2000 and 2009, 104 HCC-developed and 104 non-HCC patients were selected by eligibility criteria and propensity score matching. Samples were obtained from the HCC patients who had blood drawn annually for 3 years prior to HCC diagnosis. Results In the present study, hs-AFP-L3 was elevated 1 year prior to diagnosis in 34.3 % of patients. The survival rate of patients with the hs-AFP-L3 ≥ 7 % at 1 year prior to diagnosis was significantly lower than that of patients with hs-AFP-L3 < 7 %. Conclusions Elevation of hs-AFP-L3 was early predictive of development of HCC even at low AFP levels and in absence of ultrasound findings of suspicious HCC. The hs-AFP-L3 should be added to surveillance programs with US because elevated hs-AFP-L3 may be a trigger to perform enhanced imaging modalities for confirmation of HCC.

• Publisher: Springer Japan,Springer,Springer Nature B.V
• Subject: Abdominal Surgery / Adult / Aged / Aged, 80 and over / Alpha fetoproteins / alpha-Fetoproteins - analysis / Biliary Tract / Biomarkers, Tumor - blood / Cancer / Carcinoma, Hepatocellular - diagnosis / Carcinoma, Hepatocellular - pathology / Colorectal Surgery / Diagnosis / Early Detection of Cancer / Female / Gastroenterology / Glycoproteins / Hepatology / Hepatoma / Humans / Japan / Liver Neoplasms - diagnosis / Liver Neoplasms - pathology / Male / Medicine / Medicine & Public Health / Middle Aged / Original Article—Liver / Original —Liver, Pancreas, and Biliary Tract / Pancreas / Plant Lectins / Prognosis / Propensity Score / Retrospective Studies / Sensitivity and Specificity / Surgical Oncology / Time Factors / Young Adult