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Highly sensitive AFP‐L3% assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre‐ and postoperatively
Author(s) -
Kobayashi Masahiro,
Hosaka Tetsuya,
Ikeda Kenji,
Seko Yuya,
Kawamura Yusuke,
Sezaki Hitomi,
Akuta Norio,
Suzuki Fumitaka,
Suzuki Yoshiyuki,
Saitoh Satoshi,
Arase Yasuji,
Kumada Hiromitsu
Publication year - 2011
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2011.00858.x
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , stage (stratigraphy) , radiofrequency ablation , cutoff , alpha fetoprotein , ablation , paleontology , physics , quantum mechanics , biology
Aim: The micro‐total analysis system (µTAS), a fully automated immunoassay system using microchip capillary electrophoresis, is highly sensitive and able to quickly assay the AFP‐L3%. The clinical usefulness of this system was studied. Methods: We retrospectively enrolled 250 patients who underwent curative treatment for primary hepatocellular carcinoma (HCC) (93 patients underwent hepatic resection and 157, radiofrequency ablation [RFA]). Results: The sensitivity for µTAS AFP‐L3% was 40.3% at the cutoff value of 5% in a range of AFP less than 20 ng/mL where the conventional method was unable to determine AFP‐L3%. The sensitivity for AFP‐L3% remained high even at stage I and at tumor size less than 2 cm (42.5% and 46.0%, respectively). Recurrence rate of patients with AFP‐L3% greater than 5% was significantly higher than that of patients with less than 5% ( P = 0.001). Furthermore, in resected patients, the postoperative AFP‐L3% remained elevated with value greater than 5% was related to HCC recurrence ( P = 0.001). Multivariate analysis revealed that multiple tumors ( P = 0.004), preoperative AFP‐L3% greater than 5% ( P = 0.003), albumin less than 3.5 g/dL ( P = 0.008), and RFA ( P = 0.003) were significant prognostic factors of recurrence. Conclusions: The µTAS was found to be a highly sensitive assay for AFP‐L3% in patients with curative treatment of HCC. A cutoff value of 5% was useful for predicting recurrence after the curative treatment and detecting small tumors and early stage HCC. Additionally, postoperative AFP‐L3% was found to be a prognostic factor of HCC recurrence.