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01.08.2011 | Hepatobiliary Tumors | Ausgabe 8/2011

Annals of Surgical Oncology 8/2011

Lens Culinaris Agglutinin-Reactive Fraction of Alpha-Fetoprotein as a Marker of Prognosis and a Monitor of Recurrence of Hepatocellular Carcinoma After Curative Liver Resection

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 8/2011
Autoren:
MD Xiao-Feng Zhang, MBChB, MRCS, FRACS Eric C. H. Lai, MD Xiao-Yan Kang, BS Hai-Hua Qian, MD, PhD Yan-Ming Zhou, MD, PhD Le-Hua Shi, MD, PhD Feng Shen, MD, PhD Ye-Fa Yang, MS Yu Zhang, MD, FRCS, FACS, FRACS (Hon) Wan Yee Lau, MD Meng-Chao Wu, MD, PhD Zheng-Feng Yin

Abstract

Background

The aim of this study was to determine the role of Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) as a prognostic marker and a monitor marker of recurrence after curative resection of hepatocellular carcinoma (HCC).

Methods

From December 2002 to May 2004, 395 consecutive patients with HCC who underwent curative partial hepatectomy were included in the study. The tumor characteristics and clinical outcomes of patients with positive preoperative and postoperative AFP-L3 were compared with those with negative results.

Results

A high ratio of AFP-L3 to total AFP was an indicator of pathologic aggressiveness. Patients with positive preoperative AFP-L3 had significantly earlier recurrence (median time to recurrence 22.0 ± 2.4 months vs 45.0 ± 6.9 months, P < .001) when compared with those with negative preoperative results. Significantly more patients with continuously positive or negative-turn-positive AFP-L3 results after surgery developed recurrence, particularly distant metastases, when compared with patients with continuously negative AFP-L3 results. The overall and disease-free survivals were significantly shorter in the positive than the negative preoperative AFP-L3 group. The overall and disease-free survivals were significantly shorter in the continuously positive and the negative-turn-positive than the continuously negative postoperative AFP-L3 group.

Conclusion

Positive preoperative AFP-L3 and continuously positive or negative-turn-positive AFP-L3 results after surgery predicted a more aggressive tumor behavior, higher tumor recurrence, and poorer clinical outcomes. HCC patients with an increased proportion of AFP-L3 to total AFP should be more aggressively treated and closely followed-up.

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