Usefulness of measurement of Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein as a marker of prognosis and recurrence of small hepatocellular carcinoma

OBJECTIVE: Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3%) is a recently described marker of hepatocellular carcinoma (HCC) , and its usefulness has been demonstrated in many studies. WE: evaluated t he use fulness of serial measurement of AFP-L3% as a marker of prognosis an d recurrence after treatment of small HCC. METHODS: AFP-L3% was measured before and after initial treatment in 60 pati ents with small HCC (maxi diameter less than or equal to 2 cm). AFP-L3% was taken as the ratio of AFP-L3 to total AFP and multiplied by 100%, and leve ls greater than or equal to 10% were considered positive. Outcomes and recu rrence were compared between patients AFP-L3%-negative after initial treatm ent (Group A, n = 43) and patients who were AFP-L3%-positive after initial treatment (Group B,n = 17). RESULTS: Before treatment, AFP-L3% was positive in 14 (23.3%) of the 60 pat ients. The cumulative survival rate of Group A was significantly longer (p = 0.0091) than that of Group B. The recurrence race was significantly highe r in Group B (p = 0.0104) than in Group A. When recurrence was limited to i ntrahepatic metastasis, the recurrence rate was significantly higher in Gro up B (p = 0.0064). However, the recurrence race of multicentric occurrence did not differ significantly between Groups A and B, CONCLUSIONS: Measurement of AFP-L3% after treatment may be useful for under standing prognosis and recurrence of HCC. (C) 1999 by Am. Coil. of Gastroen terology.