Usefulness of Lens Culinaris Agglutinin - A Reactive Alpha - Fetoprotein for the Diagnosis of Hepatocelluar Carcinoma in Patients with Chronic Liver Disease Who Showed Significant Increment of Serum Alpha - Fetoprotein Level and No Mass Lesion in the Liver on Ultrasonogram

Korean J Hepatol > Volume 4(2); 1998 > Article

The Korean Journal of Hepatology 1998;4(2): 120-130.

원저 : 혈청 Alpha - Fetoprotein ( AFP ) 치가 의미있게 상승하면서 복부 초음파상 종괴가 없는 만성 간질환 환자에서 Lens Culinaris Agglutinin - A 에 반응하는 AFP 분획 측정의 간세포암 진단에 대한 유용성 ( Original Articles : Usefulness of Lens Culinaris Agglut

Usefulness of Lens Culinaris Agglutinin - A Reactive Alpha - Fetoprotein for the Diagnosis of Hepatocelluar Carcinoma in Patients with Chronic Liver Disease Who Showed Significant Increment of Serum Alpha - Fetoprotein Level and No Mass Lesion in the Liver on Ultrasonogram

June Sung Lee , Jung Hwan Yoon , Hyo Suk Lee , Chung Yong Kim

ABSTRACT

Background/Aims
' Lens culinaris agglutinin-A reactive alpha-fetoprotein (AFP L3) has been reported to be highly specific for the diagnosis of hepatocellular carcinoma (HCC). The present study was to evaluate the clinical usefulness of AFP-L3 for the diagnosis of HCC in the patients either with chronic liver disease or with HCC in complete remission who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Methods' A total numer of 34 patients (24 with chronic liver disease, 10 with HCC in complete remission) were enrolled, who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Serum AFP L3 levels were analysed by AFP differentiation kit L. Abdominal spiral CT or ultrasonogram was performed at 1-3 month intervals and all of the patients were followed up for more than 6 months. Results- Among 24 patients with chronic liver disease, two were positive (higher than 15%) for AFP L3; however, HCC was not detected in these patients, while HCCs were detected in two of 22 patients negative for AFP L3 during followe-up. Eight of the 10 patients with HCC in complete remission were positive for AFP L3; recurrent HCCs were detected in 7 of those 8 patients as well as in the rest 2 patients negative for AFP L3 during follow-up. The overall sensitivity and specificity of AFP L3 measurement for the detection of HCC within 6 months of follow-up were 63.6% and 87.0%, respectively. The positive and negative predictive value for HCC in patients with chronic liver disease were O% and 90.9% and for recurrent HCC in HCC patients in remission were 87.5% and ON, respectively. Conclusion - The measurement of AFP L3 is suggested to be useful for the diagnostic strategy in patients either with chronic liver disease or hepatocellular carcinoma in complete remission, who showed progressive increment of serum AFP level and no mass lesion in liver on ultrasonogram. (Korean J Hepatol 1998;4:120 - 130)

KeyWords: Hepatocellular carcinoma , Lens culinaris agglutinin - A reactive AFP , Recurrence , Early detection