Measuring fucosylated alpha-fetoprotein in hepatocellular carcinoma: A comparison of μTAS and parallel reaction monitoring.

PURPOSE

Fucosylation of alpha-fetoprotein (AFP) is closely correlated with the diagnosis of patients with hepatocellular carcinoma (HCC). In current, a micro-total analysis system (μTAS) using immunoassay has been developed for determining fucosylated AFP EXPERIMENTAL DESIGN: We compared two analytical methods, μTAS and liquid chromatography-parallel reaction monitoring mass spectrometry (LC-PRM MS), for the measurement of fucosylated AFP in serum to evaluate the usefulness of the results. For this purpose, serum samples were used (cirrhosis, n = 105; HCC, n = 105), and we have discussed the analytical performance of these two methods RESULTS: We observed a correlation (R  = 0.84) between LC-PRM MS and μTAS using samples where fucosylated levels were measured by both methods. The fucosylated level of AFP by LC-PRM MS better differentiated between cirrhosis and HCC patients than those by μTAS (AUC = 0.910 vs. 0.861), particularly in subgroups with a level of total AFP < 20 ng/mL (0.973 vs. 0.874) and in early stage (I and II) patients (0.922 vs. 0.835) CONCLUSIONS AND CLINICAL RELEVANCE: From this comparative study we can suggest that the LC-PRM MS is applicable in the measurement of fucosylated AFP from human serum and is more useful for early diagnosis of HCC.

CLINICAL RELEVANCE

Fucosylation of AFP is used for the detection of HCC. A micro-total analysis system (μTAS) has been only developed for measuring fucosylation of AFP in clinical research. This study reports the fucosylation of AFP in human serum samples from cirrhosis and HCC patients using the μTAS and a LC-PRM MS to evaluate fucosylation of AFP from each method. As a result, LC-PRM MS is complementary to the conventional μTAS method. Furthermore, LC-PRM MS provides a higher diagnostic accuracy than the μTAS in patients with low AFP levels and an early stage.