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Japanese Journal of Clinical Oncology 32:472-476 (2002)
© 2002 Foundation for Promotion of Cancer Research

Lectin-reactive {alpha}-Fetoprotein (AFP-L3%) Curability and Prediction of Clinical Course after Treatment of Non-seminomatous Germ Cell Tumors

Toshiyuki Kamoto1, Shinji Satomura2, Tatsuhiro Yoshiki3, Yusaku Okada3, Fumiyo Henmi2, Hiroyuki Nishiyama1, Takashi Kobayashi1, Akito Terai1, Tomonori Habuchi1 and Osamu Ogawa1,+

1 Department of Urology, Kyoto University, Graduate School of Medicine, Kyoto, 2 Osaka Research Laboratories, Wako Pure Chemical Industries Ltd, Osaka and 3 Department of Urology, Shiga University of Medical Science, Otsu, Japan

Objective: {alpha}-Fetoprotein (AFP) is an important tumor marker for non-seminomatous germ cell tumors (NSGCTs) that greatly affects diagnosis and the evaluations of therapy and therapeutic policy. However, it is sometimes very difficult to make the distinction between tumors and falsely elevated AFP levels due to benign liver disease. We assessed the usefulness of lectin-reactive {alpha}-fetoprotein (AFP-L3%), which has been reported to be superior to total AFP in both sensitivity and specificity in hepatocellular carcinomas, for the evaluation of predictions of clinical courses after the treatment of NSGCTs.

Methods: Frozen sera of 25 tumor-bearing patients with testicular cancers whose AFP levels were 5.0 ng/ml or higher were used. The total AFP levels and the ratio of L3 fraction to total AFP (AFP-L3%) were measured by liquid-phase binding assay (LBA).

Results: The total AFP levels were 6.3–14 907 ng/ml (median: 105.9 ng/ml). The median AFP-L3% was 69.9% (range;: 1.1–88.1%). Except for one patient, 24 patients (96.0%) with evident disease showed high levels of AFP-L3% of >50%, regardless of their total AFP levels. In nine patients whose sera were sequentially measured, AFP-L3% was considered highly useful for the detection of residual tumors (n = 2) and recurrence (n = 1) and for the exclusion of false-positive cases (n = 1).

Conclusions: When the total AFP level increases slightly (e.g. to 5–20 ng/ml), a measurement of AFP-L3% may provide additional useful information for monitoring NSGCT patients and in distinguishing falsely elevated AFP.

+ For reprints and all correspondence: Osamu Ogawa, Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan. E-mail: ogawao@kuhp.kyoto-u.ac.jp


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