Changes of lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3 fraction) after complete radiofrequency ablation for hepatocellular carcinoma

Background: Lens culinaris agglutinin-reactive alpha-fetuprotein (AFP-L3 fraction) is a newly developed tumor market highly specific for bepatocellular carcinoma (HCC). It is reported that serum level oi AFP-L3 tractmn is correlated well with biological malignant grade of HCC (] Gastroenterol Hepatol 2001; 16: 13781383) Aim of this stud3." is to evaluate the clinical value of the changes of AFP-L3 fraction after complete ablation of HCC by radiofrequency ablation (RFA) therapy as compared with the changes of total AFP and des-gammacarboxy prothrombin (DCP) levels. Materials and Methods: Among 371 patients with HCCs who underwent RFA, 182 tlCCs were evaluated as complete response vAth 5 mm-thick safety" margin around the tumor In 37 of those 182 HCCs, serum level of AFP-L3 fraction was pmitive betore RFA therapy. AFP-L3 fraction as ",veil as total AFP and DCP levels were serially measured over 2 years alter RFA treatment in these 37 HCC cases and its clinical significan;e was studied Results: AFP-L3 fraction level was positive in 37 of 182 HCCs (20%) Recurrence rate after complete ablated HCC m 145 cases with negative AFP-L3 value was 76% (6/145), whereas that in 37 cases with positive AFP-L3 level was 51.4% (19/37). The difference between recurrence rate in 2 groups was statistically significant. All 19 recurrence in patients with positive AFP-L3 level was found in the different region of the liver fl'om the original tlCC lesion, ie., they are not local recurrence. In these 19 HCC cases, AFP-L3 fraction level was not decreased even after complete ablation of the original ablated HCC nodules, whereas APP value and PIVKA-I1 values were decreased in most of the cases Conclusion: AFP-L3 fraction is a good prognostic indicator in HCC cases after complete ablation tor HCC. AFP-L3 fraction level was indicated to be a better index than AFP or DCP in predicting biological malignant grade or potential of intrahepatic metastasis alter complete ablation of primary lesion of HCC.