Kuromatsu R, Tanaka M, Tanikawa K
Second Department of Medicine, Kurume University School of Medicine, Japan.
Liver. 1993 Aug;13(4):177-82. doi: 10.1111/j.1600-0676.1993.tb00627.x.
A fraction of serum alpha-fetoprotein (AFP) reactive with lens culinaris agglutinin (LCA) was measured by affinity chromatography in serum samples from 102 patients with hepatocellular carcinoma (HCC) and 48 patients with chronic liver diseases without HCC. Its usefulness as a marker of HCC was evaluated. The mean +/- SD percentage of this fraction in total AFP was 3.10 +/- 3.17% in 48 patients with chronic liver diseases without HCC. When the cut-off level was set at 12.6% (mean + 3 SD), the sensitivity was 36.3%, the specificity was 100%, and the accuracy was 56.7% in the 102 patients with HCC. This lentil lectin-reactive AFP was positive in 7 of 25 patients (28%) who had single small liver cancer (phi < 20 mm), suggesting its clinical usefulness as a tumor marker. The lentil lectin-reactive AFP showed no correlation with the serum concentration of AFP or des-gamma-carboxy prothrombin (DCP). In patients with HCC showing an AFP level of 20 ng/ml or above, the lentil lectin-reactive fraction is a highly specific tumor marker. We consider it to be useful as an adjunct in the diagnosis of HCC.
采用亲和层析法测定了102例肝细胞癌（HCC）患者和48例无HCC的慢性肝病患者血清样本中与刀豆球蛋白A（LCA）反应的血清甲胎蛋白（AFP）部分。评估了其作为HCC标志物的实用性。在48例无HCC的慢性肝病患者中，该部分在总AFP中的平均±标准差百分比为3.10±3.17%。当临界值设定为12.6%（平均值+3个标准差）时，102例HCC患者的敏感性为36.3%，特异性为100%，准确性为56.7%。在25例单发小肝癌（直径<20mm）患者中，7例（28%）的这种扁豆凝集素反应性AFP呈阳性，提示其作为肿瘤标志物具有临床实用性。扁豆凝集素反应性AFP与AFP或去γ羧基凝血酶原（DCP）的血清浓度无相关性。在AFP水平≥20ng/ml的HCC患者中，扁豆凝集素反应性部分是一种高度特异性的肿瘤标志物。我们认为它作为HCC诊断的辅助手段是有用的。
