Relationship between Lens culinaris agglutinin reactive alpha-fetoprotein and biological features of hepatocellular carcinoma.

Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3), which is a fucosylated variation of AFP, is not only sensitive and specific for localization of hepatocellular carcinoma (HCC) but also a prognostic factor for patients with HCC. The relationship between status of AFP-L3% in serum and pathological findings was studied using 48 resected HCC specimens. AFP-L3 fraction was measured by lectin-affinity blotting using an AFP Differentiation Kit L (Wako, Osaka, Japan), and was expressed as AFP-L3% (AFP-L3/total AFP x 100%). A cut-off level of 15% was used. Pathological findings of HCC such as histological grade (well, moderately and poorly differentiated HCC), vascular invasion, and Ki67 (MIB1), p53 (DO7) and alpha-catenin immunohistochemical staining were studied. According to the results of serum AFP concentrations and AFP-L3%, the 48 patients were divided into the following three groups: AFP greater than or equal to 20 ng/ml and AFP-L3 positive (group A, n = 14), AFP greater than or equal to 20 ng/ml and AFP-L3 negative (group B, n = 14) and AFP less than 20 ng/ml (group C, n = 20). Ki67 labeling index of HCC tissue in group A was 27.8 +/- 18.9%, which was significantly higher than those of group B (9.6 +/- 10.1%, p < 0.024) and group C (11.1 +/- 11.2%, p < 0.03). In group A, p53 expression was higher and alpha-catenin staining was reduced significantly compared with those of group B or C, respectively. The results of the study suggest that the proportion of AFP-L3% in serum reflects some biological features of HCC.