Lens culinaris agglutinin-reactive α-fetoprotein and protein induced by vitamin K absence II are potential indicators of a poor prognosis: a histopathological study of surgically resected hepatocellular carcinoma
- 25 December 2007
- journal article
- Published by Springer Science and Business Media LLC in The Esophagus
- Vol. 42 (12), 962-968
- https://doi.org/10.1007/s00535-007-2117-x
Abstract
We histopathologically examined Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3)-positive hepatocellular carcinoma (HCC) and protein induced by vitamin K absence (PIVKA) II-positive HCC to clarify the efficacy of these markers for predicting a poor prognosis. Serum AFP-L3 and PIVKA II was measured in 110 HCC patients. AFP-L3 was measured by lectin-affinity electrophoresis coupled with antibody-affinity blotting, and PIVKA II by using a high-sensitivity kit. The growth type, capsule formation, capsule infiltration, portal vein invasion, intrahepatic metastasis and histological tumor grade were evaluated pathologically. Thirty-eight (35%) HCC patients were AFP-L3-positive, and 63 (57%) were PIVKA II-positive. In AFP-L3-positive HCC, the frequencies of an infiltrative growth type (positive : negative = 66% : 42%, P = 0.027) and a poorly differentiated type (positive : negative = 32% : 6%, P < 0.001) were significantly higher than in AFP-L3-negative HCC. In PIVKA II-positive HCC, the frequencies of an infiltrative growth type (positive : negative = 62% : 28%, P < 0.001), vascular invasion (positive : negative = 63% : 26%, P < 0.001), and intrahepatic metastasis (positive : negative = 38% : 4%, P < 0.001) were significantly higher than in PIVKA II-negative HCC. In both AFP-L3- and PIVKA II-positive HCC, the frequency of a poorly differentiated growth type was significantly higher than in HCC positive for either AFP-L3 or PIVKA II or HCC negative for both AFP-L3 and PIVKA II (both positive : either positive : both negative = 37% : 12% : 0%; P = 0.014, P < 0.001, respectively). AFP-L3 was related to progression from moderately differentiated to poorly differentiated HCC, whereas PIVKA II was more specific to vascular invasion. PIVKA II is therefore likely to be a useful indicator of vascular invasion.Keywords
This publication has 27 references indexed in Scilit:
- The des‐γ‐carboxy prothrombin index is a new prognostic indicator for hepatocellular carcinomaCancer, 2003
- Usefulness of Lens culinaris agglutinin A-reactive fraction of alpha-fetoprotein (AFP-L3) as a marker of distant metastasis from hepatocellular carcinoma.Oncology Reports, 1999
- Early hepatocellular carcinoma as an entity with a high rate of surgical cureHepatology, 1998
- Intrahepatic metastases in hepatocellular carcinoma: the role of the portal vein as an efferent vesselClinical & Experimental Metastasis, 1996
- Prognostic significance of Lens culinaris agglutinin A-reactive alpha- fetoprotein in small hepatocellular carcinomasGastroenterology, 1996
- Prospective study of α-fetoprotein in cirrhotic patients monitored for development of hepatocellular carcinomaHepatology, 1994
- Serum alpha‐fetoprotein and lens culinaris agglutinin‐reactive fraction of alpha‐fetoprotein in patients with hepatocellular carcinomaLiver International, 1993
- α-fetoprotein: Reevaluation in hepatologyHepatology, 1990
- FUCOSYLATED α-FETOPROTEIN AS MARKER OF EARLY HEPATOCELLULAR CARCINOMAThe Lancet, 1985
- Detection of Vitamin K Deficiency by Use of an Enzyme-Linked Immunosorbent Assay for Circulating Abnormal ProthrombinPediatric Research, 1985