Open AccessChanges in highly sensitive alpha‐fetoprotein for the prediction of the outcome in patients with hepatocellular carcinoma after hepatectomy
Author(s) -
Toyoda Hidenori,
Kumada Takashi,
Tada Toshifumi,
Ito Takanori,
Maeda Atsuyuki,
Kaneoka Yuji,
Kagebayashi Chiaki,
Satomura Shinji
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.218
Subject(s) - hepatocellular carcinoma , medicine , hepatectomy , gastroenterology , alpha fetoprotein , tumor marker , surgery , resection , cancer
We investigated changes in highly sensitive lens culinaris agglutinin A‐reactive fraction of alpha‐fetoprotein (hsAFP‐L3) measured using a novel method and its predictive ability for prognosis in patients with hepatocellular carcinoma ( HCC ) who underwent curative hepatectomy, comparing to other HCC tumor markers, that is, AFP , des‐gamma‐carboxy prothrombin ( DCP ), and AFP ‐L3 measured with conventional method ( cAFP ‐L3). AFP , DCP , and AFP ‐L3 including both cAFP ‐L3 and hs AFP ‐L3 were measured before and after curative hepatectomy in 187 patients. The percentage of patients with elevated tumor marker levels pre‐ and postoperatively was compared, and recurrence‐free and overall survival rates were analyzed based on changes in tumor markers. The percentages of patients with elevated AFP , DCP , and cAFP ‐L3 decreased postoperatively. In contrast, the percentage of patients with elevated hsAFP‐L3 did not decrease postoperatively. Both recurrence‐free and overall survival rates were significantly lower in patients whose tumor marker levels remained elevated postoperatively than patients without tumor marker elevation postoperatively. Recurrence‐free and overall survival rates of patients in whom hsAFP‐L3 became elevated postoperatively despite normal preoperative hsAFP‐L3 levels were significantly lower than those of patients with normal hsAFP‐L3 postoperatively, and were similar to those of patients with persistent elevation. Preoperative elevations of AFP , DCP , and cAFP normalized in many patients postoperatively, but not for hs AFP ‐L3. The elevation of hs AFP ‐L3 identifies patients with poor prognosis despite the normalization of AFP and DCP .