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Clinicopathologic features of patients with primary malignant hepatic tumors seropositive for α‐fetoprotein‐L3 alone in comparison with other patients seropositive for α‐fetoprotein‐L3
Author(s) -
OKUDA HIROAKI,
SAITO AKIKO,
SHIRATORI KEIKO,
YAMAMOTO MASAKAZU,
TAKASAKI KEN,
NAKANO MASAYUKI
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.03773.x
Subject(s) - medicine , alpha fetoprotein , hepatocellular carcinoma , gastroenterology , pathology , intrahepatic cholangiocarcinoma , hepatectomy , incidence (geometry) , carcinoma , surgery , resection , physics , optics
Background: Patients with hepatocellular carcinoma (HCC) seropositive for lectin‐reactive α‐fetoprotein (AFP‐L3) have a poor prognosis. However, there have been no studies of the clinicopathologic features of patients seronegative for both AFP and des‐γ‐carboxy prothrombin (DCP), and seropositive for AFP‐L3 alone in comparison with other patients seropositive for AFP‐L3. Methods: Patients with primary malignant hepatic tumors seropositive for AFP‐L3 who underwent hepatectomy ( n = 84) were divided into four groups, and their clinicopathologic features were compared: (i) group A, seronegative for AFP <100 ng/mL and DCP <40 mAU/mL; (ii) group B, seropositive for AFP ≥100 ng/mL and seronegative for DCP; (iii) group C, seronegative for AFP and seropositive for DCP ≥40 mAU/mL; and (iv) group D, seropositive for AFP and DCP. Results: Among the 14 group A patients seropositive for AFP‐L3 alone with low AFP concentrations, three had intrahepatic cholangiocarcinoma (ICC), one had a cholangiolocellular carcinoma, one had combined HCC and ICC, and one had undifferentiated hepatic sarcoma. Group A had a higher incidence of non‐HCC tumors ( P < 0.001) and tumors derived from cholangiocytes ( P < 0.001) than the other three groups. They also had a high frequency of poorly differentiated tumors and sarcomatous changes, and showed a poor prognosis. Conclusions: Patients with primary malignant hepatic tumors seropositive for AFP‐L3 alone with low AFP concentrations have unique clinicopathologic features. Thus, we should be aware of these patients and should measure AFP‐L3 levels, at least once, even in those seronegative for both AFP and DCP.