Clinical Significance of Lens Culinaris Agglutinin-A Reactive Alpha-Fetoprotein in Detection of the Hepatocellular Carcinoma

Kim, Shin Mook; Kim, Hyun Soo; Cho, Cheon Yeong; Kim, Ki Tae; Rew, Jong Sun; Kim, Sei Jong; Yoon, Chong Mann

Abstract

BACKGROUND AND AIMS: Alpha-fetoprotein (AFP) is the most widely used and effective tumor marker for the diagnosis of hepatocellular carcinoma (HCC), and the high titer of serum AFP is predictive of a high risk for HCC. However, the level of serum AFP has a wider overlapping zone between benign and malignant liver disease. Several studies have indicated that increased levels of several lectin-reactive AFP, including AFP that react with Lens culinaris agglutinin-A (LCA-A), could serve as an alternative index that is more specific than increased ]evels of serum AFP for HCC. The aim of this study was to determine tbe value of AFP L3 by AFP differentiation kit as a differential diagnostic method of HCC and liver cirrhosis.
METHODS
Sera were collected from 41 patients consisting of 16 patients with liver cirrhosis (LC) and 25 patients with HCC. Lectin-reactive fraction of AFP were determined by lectin affinity eclectrophoresis coupled with antibody-affinity blotting using AFP Differentiation Kit L (Wako Pure Chemical Industries. Ltd., Osaka Japan).
RESULTS
The positive rate of AFP L3 in LC and HCC was 75.0% and 96.0% respectively. AFP L3 fraction over 15% was found in 43.8% of LC and 76.0% of HCC (p<0.05). No significant correlations were found between the tumor size or serum AFP levels and AFP L3 fraction in HCC. In 10 HCC patients with serum AFP levels below 20ng/ml, cases of AFP L3 fraction over 15% were 9 patients and AFP L3 fraction of those was 37.2%.
CONCLUSIONS
These results lead us to conclude that the level of lectin-reactive AFP is a useful rnarker for diagnosis of hepatocellular carcinoma with low AFP levels.