Significance of Lens culinaris agglutinin-reactive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma

Objective To explore the clinical significance of Lens culinaris agglutinin-reactive alpha-fetoprotein in the differentiation diagnosis between benign and malignant liver diseases,as well as the warning of hepatocellular carcinoma.Methods Alpha-fetoprotein variants from 185 patients with liver diseases were isolated with micro-spin column equipped lens culinaris agglutinin (LCA).The AFP and AFP-L3 were then detected by time-resolved fluorescence immunoassay,and the proportions of AFP-L3 (AFP-L3%) were calculated.Results The AFP-L3% in patients with hepatocellular carcinoma(HCC) was significantly higher than that in patients with other liver diseases (χ2=29.329,P0.001);the area under curve of Receiver-Operating Characteristic of AFP and AFP-L3% were 0.407 and 0.841 respectively,and according as AFP-L3%≥12.6% being the diagnosis criteria,the sensitivity and specificity of patients diagnosed with liver cancer was 83.3% and 86.3% respectively.Conclusion The accuracy of AFP-L3 detection in the diagnosis of HCC was significantly higher than AFP detection.The detection of AFP-L3 by micro-spin column assay showed great clinical value in the differentiation diagnosis of HCC,especially for identifying HCC with low level of a1pha-fetoprotein.