Changes in highly sensitive alpha-fetoprotein for the prediction of the outcome in patients with hepatocellular carcinoma after hepatectomy.

Abstract

We investigated changes in highly sensitive lens culinaris agglutinin A-reactive fraction of alpha-fetoprotein (hsAFP-L3) measured using a novel method and its predictive ability for prognosis in patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy, comparing to other HCC tumor markers, that is, AFP, des-gamma-carboxy prothrombin (DCP), and AFP-L3 measured with conventional method (cAFP-L3). AFP, DCP, and AFP-L3 including both cAFP-L3 and hsAFP-L3 were measured before and after curative hepatectomy in 187 patients. The percentage of patients with elevated tumor marker levels pre- and postoperatively was compared, and recurrence-free and overall survival rates were analyzed based on changes in tumor markers. The percentages of patients with elevated AFP, DCP, and cAFP-L3 decreased postoperatively. In contrast, the percentage of patients with elevated hsAFP-L3 did not decrease postoperatively. Both recurrence-free and overall survival rates were significantly lower in patients whose tumor marker levels remained elevated postoperatively than patients without tumor marker elevation postoperatively. Recurrence-free and overall survival rates of patients in whom hsAFP-L3 became elevated postoperatively despite normal preoperative hsAFP-L3 levels were significantly lower than those of patients with normal hsAFP-L3 postoperatively, and were similar to those of patients with persistent elevation. Preoperative elevations of AFP, DCP, and cAFP normalized in many patients postoperatively, but not for hsAFP-L3. The elevation of hsAFP-L3 identifies patients with poor prognosis despite the normalization of AFP and DCP.

• Authors: Hidenori Toyoda, Takashi Kumada, Toshifumi Tada, Takanori Ito, Atsuyuki Maeda, Yuji Kaneoka, Chiaki Kagebayashi, Shinji Satomura
• Journal: Cancer medicine (Cancer Med) Vol. 3 Issue 3 Pg. 643-51 (Jun 2014) ISSN: 2045-7634 [Electronic] United States
• PMID: 24591342 (Publication Type: Journal Article)
• Copyright: © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Chemical References

• Biomarkers, Tumor
• Plant Lectins
• alpha-Fetoproteins
• lentil lectin

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor
• Carcinoma, Hepatocellular (genetics, pathology, surgery)
• Disease-Free Survival
• Female
• Hepatectomy
• Humans
• Liver Neoplasms (genetics, pathology, surgery)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (genetics, pathology, surgery)
• Plant Lectins (genetics)
• Prognosis
• Treatment Outcome
• alpha-Fetoproteins (biosynthesis, genetics)