Abstract:
BACKGROUND AND AIM:Fucosylated alpha-fetoprotein (AFP-L3) is known to be a marker of poor prognosis in patients with hepatocellular carcinoma (HCC). However, it has been difficult to measure AFP-L3 under low AFP (≤ 20 ng/mL). The aim of this study was to elucidate the role of AFP-L3 in HCC patients with low AFP conditions. METHODS:One hundred and ninety six consecutive newly developed HCC patients with low AFP (≤ 20 ng/mL) were examined for serum AFP-L3 expression by a newly-developed micro-total analysis system that could stably measure AFP-L3 in low AFP circumstances, and its clinical importance was analyzed. RESULTS:Positivity of AFP-L3 in HCC patients was 13.3% at a cut-off level of 10%. Five-year survivals of HCC patients with AFP-L3 (< 10%) and AFP-L3 (≥ 10%) were 69.4% and 41.1%, respectively (P = 0.001). Among 18 clinical parameters, low alanine aminotransferase, large tumor size, presence of portal vein tumor thrombus, high AFP and high des-gamma carboxy prothrombin were observed in the high AFP-L3 (≥ 10%) group. Multivariate analysis revealed that high aspartate aminotransferase (AST) (risk ratio [RR]= 3.24, 95% confidence interval [CI] = 1.27-8.26), the presence of ascites (RR = 3.44, 95% CI = 1.22-9.34), multiple tumor number (RR= 3.06, 95% CI = 1.33-7.17), and high AFP-L3 (RR = 8.36, 95% CI= 2.79-25.5) were risk factors for survival. High AFP-L3 was also a risk factor for survival in HCC patients who received radiofrequency ablation (P = 0.048). CONCLUSIONS:AFP-L3 is a strong prognostic factor for survival even in HCC patients with low AFP (≤ 20 ng/mL).
journal_name
J Gastroenterol Hepatoljournal_title
Journal of gastroenterology and hepatologyauthors
Nouso K,Kobayashi Y,Nakamura S,Kobayashi S,Takayama H,Toshimori J,Kuwaki K,Hagihara H,Onishi H,Miyake Y,Ikeda F,Shiraha H,Takaki A,Iwasaki Y,Kobashi H,Yamamoto Kdoi
10.1111/j.1440-1746.2011.06720.xsubject
Has Abstractpub_date
2011-07-01 00:00:00pages
1195-200issue
7eissn
0815-9319issn
1440-1746journal_volume
26pub_type
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