HCC肿瘤标记物 AFP-L3
甲胎蛋白异质体（AFP-L3）是肝细胞癌（HCC）的血清标记物。
临床意义
研究显示，AFP-L3值升高（≧10%）与慢性肝病患者发展为HCC的风险增加有关。
在可以通过影像学检出HCC之前，AFP-L3可以提示HCC的早期发展，并且可用于识别高风险HCC患者[1-4]。
AFP-L３的升高与HCC发展的各个阶段相关。据报道，AFP-L3值上升预示着发展为HCC的恶性程度升高，肿瘤体积的倍增时间缩短，肝动脉供血量增大[5]。AFP-L3值也与HCC的病理特征相关，如浸润性肿瘤生长模式，包膜浸润和血管侵袭[6]。
国际肝病权威组织认为肝硬化患者和慢性乙肝/丙肝患者发展为HCC的风险很高[7-9]。他们建议高危患者参加HCC监测项目，以便及早发现HCC。日本肝病学会建议将超声和肿瘤标记物（包括AFP-L3，AFP和异常凝血酶原（PIVKA II））用于HCC临床监测。对于任何HCC肿瘤标记物升高的患者，应通过加强影像学检查方式进行监测[9]。
和光新开发的全自动电泳荧光免疫分析仪（µTASWako i30），针对血清AFP-L3测定，具有较高的分析灵敏度，在早期HCC患者中，也表现出较高的临床敏感性[4，10-12]。
HCC是一种即使在治愈性治疗后也具有较高复发率的癌症。AFP-L3水平较高的患者可能发展为复发性HCC[13，14]。
AFP-L3值升高预示着肿瘤的恶性程度增加，并且与HCC患者预后不良相关。
JSH建议对于治疗后的患者，应结合超声和HCC肿瘤标记物持续对患者进行监测，以便及早发现复发性HCC[15]。
如何检测
µTASWako i30用于体外诊断，并同时测定AFP-L3和PIVKA II。
请访问"PIVKA II"页面了解更多信息。
AFP-L3和PIVKA II试剂在全球均有销售，在美国和日本已纳入医保。如需了解更多的订购信息，请联系
wako.info02@fujifilm.com
References
- Sato Y, et al. Early recognition of hepatocellular carcinoma based on altered profiles of alpha-fetoprotein. N. Engl. J. Med. 1993; 328: 1802-6.
- Oka H, et al. Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive alpha-fetoprotein. J. Gastroenterol. Hepatol. 2001; 16: 1378-83.
- Taketa K, et al. A collaborative study for the evaluation of lectin-reactive a-fetoproteins in early detection of hepatocellular carcinoma. Cancer Res. 1993; 53: 5419-23.
- Shiraki K, et al. A clinical study of lectin-reactive alpha-fetoprotein as an early indicator of hepatocellular carcinoma in the follow-up of cirrhotic patients. Hepatology 1995; 22: 802-7.
- Shimauchi Y, et al. A simultaneous monitoring of Lens culinaris agglutinin A-reactive alpha-fetoprotein and desgamma-carboxy prothrombin as an early diagnosis of hepatocellular carcinoma in the follow-up of cirrhotic patients. Oncol. Rep. 2000; 7: 249-56.
- Oda K, et al. Highly sensitive lens culinaris agglutinin-reactive a-fetoprotein is useful for early detection of hepatocellular carcinoma in patients with chronic liver disease. Oncol. Rep. 2011; 26: 1227-33.
- Kumada T, et al. Clinical utility of Lens culinaris agglutinin-reactive alpha-fetoprotein in small hepatocellular carcinoma: special reference to imaging diagnosis. J. Hepatol. 1999; 30: 125-30.
- Tada T, et al. Relationship between Lens culinaris agglutinin-reactive alpha-fetoprotein and pathologic features of hepatocellular carcinoma. Liver Int. 2005; 25: 848-53.
- Heimbach JK, et al. AASLD Guidelines for the Treatment of Hepatocellular Carcinoma: Hepatology. 2018 Jan; 67 (1): 358-380
- EASL Clinical Practice Guideline: Management of hepatocellular carcinoma: J. Hepatol. 69 (2018) 182-236
- Kokuno N, et al. Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma: The Japan Society of Hepatology 2013 update (3rd JSH-HCC Guidelines). Hepatol. Res. 2015 Jan 45 (2)
- Choi JY, et al. Diagnostic value of AFP-L3 and PIVKA-II in hepatocellular carcinoma according to total-AFP. World J. Gastroenterol. 2013; 19: 339-46.
- Hann HW, et al. Usefulness of highly sensitive AFP-L3 and DCP in surveillance for hepatocellular carcinoma in patients with a normal alpha-fetoprotein. J. Med. Microb. Diagn. 2014, 3:1
- Choi J, et al. Longitudinal Assessment of Three Serum Biomarkers to Detect Very Early-Stage Hepatocellular Carcinoma. Hepatology. 2018 Aug. 28
- Toyoda H, et al. Clinical utility of highly sensitive Lens culinaris agglutinin-reactive alpha-fetoprotein in hepatocellular carcinoma patients with alpha-fetoprotein > 20 ng/mL. Cancer 2011 May; 102 (5) 1025-31
- Toyoda H, et al. Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy. J. Hepatol. 2012 Dec; 57(6): 1251-7
- Kobayashi M, et al. Highly sensitive AFP-L3% assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre- and postoperatively. Hepatol. Res. 2011 Nov; 41(11): 1036-45
- Sato Y, et al. Early recognition of hepatocellular carcinoma based on altered profiles of alpha-fetoprotein. N. Engl. J. Med. 1993; 328:1802-6.
- Oka H, et al. Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive alpha-fetoprotein. J. Gastroenterol. Hepatol. 2001; 16:1378-83.
