PT  - JOURNAL ARTICLE
AU  - TAKANOBU YAMAO
AU  - YO-ICHI YAMASHITA
AU  - KATSUNORI IMAI
AU  - NAOKI UMEZAKI
AU  - MASAYO TSUKAMOTO
AU  - YUKI KITANO
AU  - KOTA ARIMA
AU  - TATSUNORI MIYATA
AU  - SHIGEKI NAKAGAWA
AU  - HIROHISA OKABE
AU  - HIROMITSU HAYASHI
AU  - AKIRA CHIKAMOTO
AU  - TAKATOSHI ISHIKO
AU  - HIDEO BABA
TI  - Clinical Significance of Preoperative Hepatocellular Carcinoma With High <em>Lens culinaris</em> Agglutinin-reactive Fraction of Alpha-Fetoprotein, But Low Alpha-Fetoprotein
AID  - 10.21873/anticanres.13189
DP  - 2019 Feb 01
TA  - Anticancer Research
PG  - 883--889
VI  - 39
IP  - 2
4099  - http://ar.iiarjournals.org/content/39/2/883.short
4100  - http://ar.iiarjournals.org/content/39/2/883.full
SO  - Anticancer Res2019 Feb 01; 39
AB  - Background: The aim of this study was to verify the significance of high Lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3) in patients with hepatocellular carcinoma (HCC) with low AFP. Materials and Methods: There were 283 patients with low AFP who underwent initial hepatic resection with or without radiofrequency ablation for HCC. Patients were divided into two groups based on AFP-L3 values: >10%: high AFP-L3 (n=24); and ≤10%: low AFP-L3 (n=259). Overall survival (OS) and 2-year recurrence rates were compared, and independent prognostic factors were identified. Results: The OS and 2-year recurrence rates of the high AFP-L3 group were significantly worse than those of the low AFP-L3 group. The independent prognostic factors for poor OS were des-gamma-carboxy prothrombin (DCP) of >40 mAU/ml, microvascular invasion, and invasive growth, and those for 2-year recurrence were 99mTc-galactosyl human serum albumin uptake ratio of <0.90, DCP of >40 mAU/ml, multiple tumors, microvascular invasion, and poor differentiation. DCP levels increased with AFP-L3, and cases with high DCP and AFP-L3 had worse prognoses and higher 2-year recurrence rates compared to those with elevation of only one of these. Conclusion: Patients with high AFP-L3 but low AFP have poor prognosis and high 2-year recurrence rates. DCP strongly reflects HCC malignancy in patients with low AFP.