TY - JOUR T1 - Clinical Significance of Preoperative Hepatocellular Carcinoma With High <em>Lens culinaris</em> Agglutinin-reactive Fraction of Alpha-Fetoprotein, But Low Alpha-Fetoprotein JF - Anticancer Research JO - Anticancer Res SP - 883 LP - 889 DO - 10.21873/anticanres.13189 VL - 39 IS - 2 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 Y1 - 2019/02/01 UR - http://ar.iiarjournals.org/content/39/2/883.abstract N2 - 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: &gt;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 &gt;40 mAU/ml, microvascular invasion, and invasive growth, and those for 2-year recurrence were 99mTc-galactosyl human serum albumin uptake ratio of &lt;0.90, DCP of &gt;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. ER -