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A clinical study of lectin-reactive alpha-fetoprotein as an early indicator of hepatocellular carcinoma in the follow-up of cirrhotic patients.

Abstract
Levels of two types of lectin-reactive alpha-fetoprotein (AFP), designated AFP-L3 and AFP-P4+P5, were analyzed with Lens culinaris agglutinin A and AFP-P4+P5 with erythroagglutinating phytohemagglutinin, respectively, in an attempt to determine the utility and significance of these macromolecules as early indicators of hepatocellular carcinoma during the periodic follow-up of cirrhotic patients. The subjects were 51 of 190 consecutive cirrhotic patients in whom hepatocellular carcinoma developed during a 6-year follow-up period and 21 cirrhotic patients without hepatocellular carcinoma. Serum AFP levels were of limited value to diagnose and predict hepatocellular carcinoma. The relative levels of AFP-L3 and AFP-P4+P5 in patients with hepatocellular carcinoma at the time of tumor detection were significantly higher than those in patients with cirrhosis. The sensitivity was 61%, and the specificity was 90%. Fourteen patients (48%) of 29 patients with small hepatocellular carcinomas less than 2 cm in diameter showed elevated percentage of lectin-reactive AFP. Retrospective examination of 21 patients who were positive for lectin-reactive AFP at diagnosis of hepatocellular carcinoma showed that 41% of them had already expressed lectin-reactive AFP 12 months before the direct detection of hepatocellular carcinoma by diagnostic imaging. These results lead us to conclude that the level of lectin-reactive AFP is a suitable predictive marker for the early recognition of hepatocellular carcinoma in the follow-up of patients with cirrhosis, and that measurements of the level of lectin-reactive AFP should be added to the screening methods that are now in use.
AuthorsK Shiraki, K Takase, Y Tameda, M Hamada, Y Kosaka, T Nakano
JournalHepatology (Baltimore, Md.) (Hepatology) Vol. 22 Issue 3 Pg. 802-7 (Sep 1995) ISSN: 0270-9139 [Print] United States
PMID7544756 (Publication Type: Journal Article)
Chemical References
  • Biomarkers, Tumor
  • Lectins
  • alpha-Fetoproteins
Topics
  • Biomarkers, Tumor (analysis)
  • Carcinoma, Hepatocellular (diagnosis)
  • Female
  • Follow-Up Studies
  • Humans
  • Lectins
  • Liver Cirrhosis (therapy)
  • Liver Neoplasms (diagnosis)
  • Male
  • Middle Aged
  • Radioimmunoassay
  • Time Factors
  • alpha-Fetoproteins (analysis)

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