Digestive Diseases and Sciences

, Volume 52, Issue 3, pp 776–782 | Cite as

Clinical Evaluation of Lens Culinaris Agglutinin-Reactive α-Fetoprotein and Des-γ-Carboxy Prothrombin in Histologically Proven Hepatocellular Carcinoma in the United States

  • Brian I. Carr
  • Futoshi Kanke
  • Margaret Wise
  • Shinji Satomura
Original Paper


There is no established clinical role for the lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3%) and des-γ-carboxy prothrombin (DCP) in the management of the U.S. hepatocellular carcinoma (HCC) patient population. In order to clarify the clinical usefulness and characteristics of AFP-L3% and DCP, a prospective study was performed on United States patients having histologically proven hepatocellular carcinoma. Ninety-nine histologically proven HCC patients, who were diagnosed with unresectable cancer between July 1999 and March 2001 at the Liver Cancer Center of the University of Pittsburgh Medical Center, were included for analysis. The sensitivity of AFP-L3%, DCP, and AFP was 61.6%, 72.7%, and 67.7%, respectively. The highest sensitivity, 85.9%, was obtained in the combination of three markers. Statistically significant differences were observed for portal vein invasion in AFP-L3% and AFP levels (P=0.0059 and P=0.0360, respectively). DCP was significantly associated with metastasis (P=0.0368). There were significant associations between AFP-L3% and AFP results and patient survival (P=0.0150 and P=0.0020, respectively). AFP-L3%, platelet count,and albumin showed a significant difference with respect to outcomes on Cox’s proportional hazard model (P=0.0059, P=0.0073, and P=0.0265, respectively). The combination of AFP-L3%, DCP, and AFP was determined to be superior for detection of HCC compared with each marker alone or to other combinations. AFP-L3% was significantly related to portal vein invasion and patient outcomes and appears to be a useful prognostic marker for HCC.


Lens culinaris agglutinin-reactive fraction of α-fetoprotein Des-γ-carboxy prothrombin (DCP) α-Fetoprotein Hepatocellular carcinoma Prognosis 



This work was supported in part by NIH Grant CA 82723 (to B.I.C.).


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Brian I. Carr
    • 1
  • Futoshi Kanke
    • 2
  • Margaret Wise
    • 3
  • Shinji Satomura
    • 2
  1. 1.Liver Cancer CenterStarzl Transplantation Institute, University of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Diagnostics DivisionWako Pure Chemical Industries, Ltd.OsakaJapan
  3. 3.Diagnostics DivisionWako Chemicals USA, Inc.RichmondUSA

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