Evaluation of curability and prediction of prognosis after surgical treatment for hepatocellular carcinoma by lens culinaris agglutinin-reactive alpha-fetoprotein

The clinical significance of serum lens culinaris agglutinin-reactive alpha -fetoprotein (AFP-L3), which can distinguish between hepatocellular carcino ma and hepatitis by detecting a sugar chain micro heterogeneity, was evalua ted for its possible ability to recognize previously undetectable residual tumors, and for increasing the accuracy of prognosis after surgical treatme nt for hepatocellular carcinoma. Serum lens culinaris agglutinin-reactive a lpha-fetoprotein was measured pre- and post-operatively in 130 patients who underwent curative surgical treatment for hepatocellular carcinoma. The pr eoperative AFP-L3 positive rate was 35.4%. AFP-L3 remained positive postope ratively in 28 of the 46 preoperative AFP-L3 positive patients, and convert ed to positive in 4 of the 84 preoperative AFP-L3 negative patients. Regard less to preoperative AFP-L3, the postoperative AFP-L3 positive patients had a poorer recurrence-free rate (p<0.0001). The postoperative L3 positive pa tients had a high incidence of recurrence due to metastasis, but did not ha ve recurrence due to multicentric origin. Multivariate analysis revealed th at AFP-L3 (p<0.0001) was the most independently significant factor for pred icting survival after surgery among several conventional prognostic factors . Thus, AFP-L3 is a valuable marker for evaluation of curability of surgica l treatment and for improving the accuracy of prognosis.