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A Collaborative Study for the Evaluation of Lectin-Reactive -Fetoproteins in Early Detection of Hepatocellular Carcinoma

Department of Public Health, Okayama University Medical School, Okayama [K. T.], Sanraku Hospital, Tokyo [Y. E.]; Third Department of Medicine, Asahikawa Medical College, Asahikawa [C. S.]; Second Department of Medicine, Kurume University, Kurume [K. T.]; Health Research Center, Nagasaki University, Nagasaki [T. K.], Osaka Research Laboratories, Wako Pure Chemical Industries Ltd., Amagasaki [S. S., S. M.]; Department of Clinical Pathology, Jichi Medical School, School of Medicine, Tochigi [T. K.]; and Tumor Laboratory, Tokyo [H. T., H. H.], Japan

Lectin-affinity electrophoretic separation of serum -fetoprotein (AFP) was carried out using AFP Differentiation Kits, which used Lens culinaris agglutinin-A (Kit L) and erythroagglutinating phytohemagglutinin (Kit P). Separated AFP bands were detected with a sensitive antibody-affinity blotting technique and determined quantitatively by densitometry, and the results were expressed as percentages of the intensity of total AFP bands. Sera from 424 patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and extrahepatic tumors were assayed for proportion of AFP present as Lens culinaris agglutinin-A-reactive AFP (AFP-L3) and erythroagglutinating phytohemagglutinin-reactive AFPs (AFP-P4+P5). From the maximum Youden indices determined, cutoff levels were set at 15% for both AFP-L3 and AFP-P4+P5 to discriminate between patients with chronic hepatitis and liver cirrhosis and patients with hepatocellular carcinoma. AFP-L3 and AFP-P4+P5 showed sensitivities of 55.3 and 61.0% at specificities of 93.9% and 82.3%, respectively. Thirty-eight % of tumors that measured less than 20 mm in diameter were positive for AFP-L3 and AFP-P4+P5. AFP-L3 exceeded the cutoff level of 15% 4.0±4.9 months before detection of hepatocellular carcinomas by imaging techniques with a sensitivity of 48% and a specificity of 81%. Thus, these tests are useful for the early detection of hepatocellular carcinomas in patients with hepatitis or liver cirrhosis.

¹ To whom requests for reprints should be addressed, at Osaka Research Laboratories, Wako Pure Chemical Industries, Ltd., 6-1 Takada-cho, Amagasaki, Hyogo 661, Japan.

Received 4/ 2/93. Accepted 9/ 8/93.

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