Clinical significance of the highly sensitive fucosylated fraction of α-fetoprotein in patients with chronic liver disease

被引：23
作者：
Hanaoka, Takuya [1 ]
Sato, Shuichi [1 ]
Tobita, Hiroshi [1 ]
Miyake, Tatsuya [1 ]
Ishihara, Shunji [1 ]
Akagi, Shuji [3 ]
Amano, Yuji [2 ]
Kinoshita, Yoshikazu [1 ]
机构：
[1] Shimane Univ, Sch Med, Dept Gastroenterol & Hepatol, Fac Med, 89-1 Enya Cho, Izumo, Shimane 6938501, Japan
[2] Shimane Univ Hosp, Div Gastrointestinal Endoscopy, Izumo, Shimane, Japan
[3] Oda City Hosp, Div Internal Med, Oda, Japan
来源：
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY | 2011年 / 26卷 / 04期
关键词：
alpha-fetoprotein; chronic liver disease; fucosylated fraction; hepatocellular carcinoma; AGGLUTININ-REACTIVE FRACTION; SMALL HEPATOCELLULAR-CARCINOMA; DES-GAMMA-CARBOXYPROTHROMBIN; 3; TUMOR-MARKERS; PROGNOSTIC-SIGNIFICANCE; CARBOXY PROTHROMBIN; ON-CHIP; CIRRHOSIS; UTILITY; RECURRENCE;
D O I：
10.1111/j.1440-1746.2010.06585.x
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
Background and Aim: The purpose of the present study was to investigate the clinical significance of the highly sensitive fucosylated fraction of alpha-fetoprotein (hs-AFP-L3) in patients with chronic liver disease (CLD) and low serum alpha-fetoprotein (AFP) concentration. Methods: A total of 241 patients being treated at our institute with CLD and low serum AFP concentration (3-10 ng/mL) were investigated retrospectively. We measured total AFP and the percentage of AFP-L3 using a mu TAS Wako i30 device. The possible presence of hepatocellular carcinoma (HCC) was thoroughly investigated by various examinations carried out from 1 month before to 1 month after measurements. In addition, hs-AFP-L3 elevated and non-elevated groups, divided by the cut-off value based on a receiver-operator characteristic (ROC) curve, were followed for possible future development of HCC. Results: hs-AFP-L3 was above the detectable range in 60 patients (24.9%). Among those AFP-L3 positive cases, 20 (33.3%) were found to be HCC prevalent, whereas HCC was found in just 16 patients (8.8%) with undetectable hs-AFP-L3 levels. We determined the cut-off value of hs-AFP-L3%, which shows the proportion of AFP L3 in total AFP, to be 5.75%. During the follow-up period, HCC was newly detected in six patients (22.2%) in the hs-AFP-L3% elevated group and in 10 (5.6%) in the non-elevated group. Analysis using the Kaplan-Meier method showed the HCC-free rate of the hs-AFP-L3% elevated group was significantly lower than that of the non-elevated group (P = 0.0038). Independent predicting variants were female sex (P = 0.0024) and hs-AFP-L3% elevation (P = 0.0036). Conclusion: Our results suggest hs-AFP-L3 level is a useful tumor marker for HCC in patients with CLD and low serum AFP concentration.
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页码：739 / 744
页数：6
相关论文
共 25 条
[1]   HEPATOCELLULAR-CARCINOMA [J].
DIBISCEGLIE, AM ;
RUSTGI, VK ;
HOOFNAGLE, JH ;
DUSHEIKO, GM ;
LOTZE, MT .
ANNALS OF INTERNAL MEDICINE, 1988, 108 (03) :390-401
[2]   Des-γ-carboxyprothrombin, α-fetoprotein and AFP-L3 in patients with chronic hepatitis, cirrhosis and hepatocellular carcinoma [J].
Durazo, Francisco A. ;
Blatt, Lawrence M. ;
Corey, William G. ;
Lin, Jiing-Huey ;
Han, Steven ;
Saab, Sammy ;
Busuttil, Ronald W. ;
Tong, Myron J. .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2008, 23 (10) :1541-1548
[3]   Prognostic factors for portal venous invasion in patients with hepatocellular carcinoma [J].
Hagiwara, Satoru ;
Kudo, Masatoshi ;
Kawasaki, Toshihiko ;
Nagashima, Miki ;
Minami, Yasunori ;
Chung, Hobyung ;
Fukunaga, Toyokazu ;
Kitano, Masayuki ;
Nakatani, Tatsuya .
JOURNAL OF GASTROENTEROLOGY, 2006, 41 (12) :1214-1219
[4]   Usefulness of measurement of Lens culinaris agglutinin-reactive fraction of α-fetoprotein as a marker of prognosis and recurrence of small hepatocellular carcinoma [J].
Hayashi, K ;
Kumada, T ;
Nakano, S ;
Takeda, I ;
Sugiyama, K ;
Kiriyama, S ;
Sone, Y ;
Miyata, A ;
Shimizu, H ;
Satomura, S .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 1999, 94 (10) :3028-3033
[5]   Automated immunoassay system for AFP-L3% using on-chip electrokinetic reaction and separation by affinity electrophoresis [J].
Kagebayashi, Chiaki ;
Yamaguchi, Isao ;
Akinaga, Ayumi ;
Kitano, Hiromichi ;
Yokoyama, Kazunori ;
Satomura, Masahiro ;
Kurosawa, Tatsuo ;
Watanabe, Mitsuo ;
Kawabata, Tomohisa ;
Chang, William ;
Li, Chen ;
Bousse, Luc ;
Wada, Henry G. ;
Satomura, Shinji .
ANALYTICAL BIOCHEMISTRY, 2009, 388 (02) :306-311
[6]   Electrokinetic Analyte Transport Assay for α-fetoprotein immunoassay integrates mixing, reaction and separation on-chip [J].
Kawabata, Tomohisa ;
Wada, Henry G. ;
Watanabe, Mitsuo ;
Satomura, Shinji .
ELECTROPHORESIS, 2008, 29 (07) :1399-1406
[7]   Clinical evaluation of lentil lectin-reactive alpha-fetoprotein-L3 in histology-proven hepatocellular carcinoma [J].
Khien, VV ;
Mao, HV ;
Chinh, TT ;
Ha, PT ;
Bang, MH ;
Lac, BV ;
Hop, TV ;
Tuan, NA ;
Don, LV ;
Taketa, K ;
Satomura, S .
INTERNATIONAL JOURNAL OF BIOLOGICAL MARKERS, 2001, 16 (02) :105-111
[8]   Fucosylated fraction of alpha-fetoprotein, L3, as a useful prognostic factor in patients with hepatocellular carcinoma with special reference to low concentrations of serum alpha-fetoprotein [J].
Kobayashi, Makoto ;
Kuroiwa, Takashi ;
Suda, Takeshi ;
Tamura, Yasushi ;
Kawai, Hirokazu ;
Igarashi, Masato ;
Fukuhara, Yasuo ;
Aoyagi, Yutaka .
HEPATOLOGY RESEARCH, 2007, 37 (11) :914-922
[9]   α-Fetoprotein, Des-γ Carboxyprothrombin, and Lectin-Bound α-Fetoprotein in Early Hepatocellular Carcinoma [J].
Marrero, Jorge A. ;
Feng, Ziding ;
Wang, Yinghui ;
Nguyen, Mindie H. ;
Befeler, Alex S. ;
Roberts, Lewis R. ;
Reddy, K. Rajender ;
Harnois, Denise ;
Llovet, Josep M. ;
Normolle, Daniel ;
Dalhgren, Jackie ;
Chia, David ;
Lok, Anna S. ;
Wagner, Paul D. ;
Srivastava, Sudhir ;
Schwartz, Myron .
GASTROENTEROLOGY, 2009, 137 (01) :110-118
[10]   Lens culinaris agglutinin-reactive α-fetoprotein and protein induced by vitamin K absence II are potential indicators of a poor prognosis:: a histopathological study of surgically resected hepatocellular carcinoma [J].
Miyaaki, Hisamitsu ;
Nakashima, Osamu ;
Kurogi, Mina ;
Eguchi, Katsumi ;
Kojiro, Masamichi .
JOURNAL OF GASTROENTEROLOGY, 2007, 42 (12) :962-968
123