Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Hepatol Res. 2011 Nov;41(11):1036-45. doi: 10.1111/j.1872-034X.2011.00858.x. Epub 2011 Aug 26.
The micro-total analysis system (µTAS), a fully automated immunoassay system using microchip capillary electrophoresis, is highly sensitive and able to quickly assay the AFP-L3%. The clinical usefulness of this system was studied.
We retrospectively enrolled 250 patients who underwent curative treatment for primary hepatocellular carcinoma (HCC) (93 patients underwent hepatic resection and 157, radiofrequency ablation [RFA]).
The sensitivity for µTAS AFP-L3% was 40.3% at the cutoff value of 5% in a range of AFP less than 20 ng/mL where the conventional method was unable to determine AFP-L3%. The sensitivity for AFP-L3% remained high even at stage I and at tumor size less than 2 cm (42.5% and 46.0%, respectively). Recurrence rate of patients with AFP-L3% greater than 5% was significantly higher than that of patients with less than 5% (P = 0.001). Furthermore, in resected patients, the postoperative AFP-L3% remained elevated with value greater than 5% was related to HCC recurrence (P = 0.001). Multivariate analysis revealed that multiple tumors (P = 0.004), preoperative AFP-L3% greater than 5% (P = 0.003), albumin less than 3.5 g/dL (P = 0.008), and RFA (P = 0.003) were significant prognostic factors of recurrence.
The µTAS was found to be a highly sensitive assay for AFP-L3% in patients with curative treatment of HCC. A cutoff value of 5% was useful for predicting recurrence after the curative treatment and detecting small tumors and early stage HCC. Additionally, postoperative AFP-L3% was found to be a prognostic factor of HCC recurrence.
微全分析系统（µTAS）是一种完全自动化的免疫分析系统，使用微芯片毛细管电泳，具有高度的敏感性，能够快速检测 AFP-L3%。研究了该系统的临床应用价值。
我们回顾性地纳入了 250 名接受原发性肝细胞癌（HCC）根治性治疗的患者（93 例行肝切除术，157 例行射频消融术[RFA]）。
µTAS AFP-L3%的截断值为 5%时，在 AFP 小于 20ng/mL 的范围内，对 AFP-L3%的检测灵敏度为 40.3%，而传统方法无法确定 AFP-L3%。即使在 I 期和肿瘤直径小于 2cm 时，AFP-L3%的灵敏度仍然较高（分别为 42.5%和 46.0%）。AFP-L3%大于 5%的患者的复发率明显高于 AFP-L3%小于 5%的患者（P=0.001）。此外，在接受肝切除术的患者中，术后 AFP-L3%仍保持升高，且值大于 5%与 HCC 复发相关（P=0.001）。多变量分析显示，多个肿瘤（P=0.004）、术前 AFP-L3%大于 5%（P=0.003）、白蛋白小于 3.5g/dL（P=0.008）和 RFA（P=0.003）是复发的显著预后因素。
µTAS 被发现是一种高度敏感的 AFP-L3%检测方法，适用于接受 HCC 根治性治疗的患者。截断值为 5%有助于预测根治性治疗后的复发，并能检测到小肿瘤和早期 HCC。此外，术后 AFP-L3%是 HCC 复发的预后因素。
