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- Title
Prognostic importance of fucosylated alpha-fetoprotein in hepatocellular carcinoma patients with low alpha-fetoprotein.
- Authors
Nouso, Kazuhiro; Kobayashi, Yoshiyuki; Nakamura, Shinichiro; Kobayashi, Sayo; Takayama, Hiroki; Toshimori, Junichi; Kuwaki, Kenji; Hagihara, Hiroaki; Onishi, Hideki; Miyake, Yasuhiro; Ikeda, Fusao; Shiraha, Hidenori; Takaki, Akinobu; Iwasaki, Yoshiaki; Kobashi, Haruhiko; Yamamoto, Kazuhide
- Abstract
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. 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. 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). AFP-L3 is a strong prognostic factor for survival even in HCC patients with low AFP (≤ 20 ng/mL).
- Subjects
ALPHA fetoproteins; LIVER cancer patients; ALANINE aminotransferase; TUMOR blood vessels; PORTAL vein
- Publication
Journal of Gastroenterology & Hepatology, 2011, Vol 26, Issue 7, p1195
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2011.06720.x