Analysis of serum alpha-fetoprotein-L3% and des-gamma carboxyprothrombin markers in cases with misleading hepatocellular carcinoma total alpha-fetoprotein levels

作者：Hadziyannis Emilia^*; Sialevris Konstantinos; Georgiou Anastasia; Koskinas John

来源：Oncology Reports, 2013, 29(2): 835-839.

DOI：10.3892/or.2012.2147

• alpha-fetoprotein
• alpha-fetoprotein-L3%
• des-gamma carboxyprothrombin
• hepatocellular carcinoma
• tumor marker

Serum fraction of alpha-fetoprotein L3 (AFP-L3%) and des-gamma carboxyprothrombin (DCP) are proposed serum markers for the diagnosis of hepatocellular carcinoma (HCC). We evaluated their performance in two patient populations with total AFP levels non-diagnostic for HCC. From a cohort of 150 consecutive patients with HCC, 60 patients with total AFP %26lt;200 ng/ml were identified. Additionally, 50 patients with elevated AFP and no radiological evidence of HCC, for at least one year of follow-up, were included. AFP-L3% and DCP were measured by the Liquid Phase Binding Assay System (LiBASys). In cases where AFP-L3% was undetectable, a more sensitive method based on-chip electrokinetic reaction was applied. AFP-L3% was found to be positive in 22 (36.7%) of patients with HCC and 6 (12%) of non-HCC patients. DCP was found to be positive in 26 patients with HCC (43%) and in none of the non-HCC patients. Thirty-six out of sixty (60%) patients with HCC were positive for either AFP-L3% or DCP. With the on-chip technology, AFP-L3% was found to be positive in 10 patients with HCC and in 5 patients without HCC, who tested negative by LiBASys. The final sensitivity of combined AFP, AFP-L3% and DCP testing, in the entire cohort of patients with HCC, was 84%. The specificity of AFP-L3% and DCP in the studied population was 78.5 and 100%, respectively. The addition of AFP-L3% and DCP increased the sensitivity and specificity of total serum AFP for the diagnosis of HCC. The on chip AFP-L3% assay was more sensitive but less specific compared to LiBASys.

• 出版日期2013-2