[Early detection of hepatocellular carcinoma with lectin reactive alpha-fetoprotein]

Lens culimaris agglutinin A-reactive alpha-fetoprotein (AFP L3) and erythroagglutinating phytohemagglutin-reactive alpha-fetoprotein (AFP P4 + P5) were determined by a sensitive method using lectin-affinity electrophoresis coupled with antibody-affinity blotting, and the usefulness of this method for early detection of hepatocellular carcinoma (HCC) was examined. For 72 operated cases of the HCC group including 28 cases of small liver cancer, the AFP value was 124 +/- 198ng/ml (Mean +/- SD); the lectin fraction values for L3 and P4 + P5 were 12.2 +/- 17.9 and 17.9 +/- 17.9%, respectively, which were significantly higher compared with the chronic hepatitis (CH).cirrhosis (LC) group and showed an increasing tendency with an increase in tumor diameter. The cut-off values for distinguishing HCC from CH.LC, determined with the receiver-operating characteristic (ROC) plots, were 10.0 and 15.0% for the L3 and P4 + P5 fractions, respectively, and the positive rates in the patient with HCC were 33.3 and 48.6% for AFP L3 and AFP P4 + P5, respectively, and 59.7% with a combination assay. For small liver cancer, the positive rate was 17.9% with protein induced by vitamin K absence-II (PIVKA-II) and 46.4% with combination assay of AFP L3 and AFP P4 + P5. Also, for HCC below AFP 50ng/ml, a positive rate of 45.0% was obtained. In the CH.LC group, all cases were negative for AFP L3 and 2 of 44 cases (4.5%) were false-positive for AFP P4 + P5.