The diagnostic value of hepatocellular carcinoma by AFP-L3 variant determined in AFP low concentrations

Objective To explore the clinical value of alpha-fetoprotein variant (AFP-L3) percentage in the early diagnosis of hepatocellular carcinoma (HCC) and the operation evaluation in the patients with low serum AFP level.Methods AFP-L3 variants from 245 patients (including 100 cases of cirrhosis and 145 cases of HCC) with low serum AFP level(5-40 ng/ml) were isolated and the contents of AFP-L3 variant and total serum AFP were measured to get AFP-L3％ (the ratio of AFP-L3 to total AFP).The follow-up of 3 months for 100 cirrhosis patients and 12 months for 20 HCC patients who underwent operation were performed.Results Using AFP-L3％ ≥ 10％ as a positive criterion,there was a positive rate of 23％ with AFP-L3％ in 100 cases of cirrhosis,and 8 out of 23 cases of AFP-L3 positive were diagnosed to be HCC after 3 months.There was a positive rate of 46.2％ with AFP-L3％ in 145 cases of HCC with low serum AFP level.AFP-L3％ level was significantly higher in HCC than those in cirrhosis (t =7.318,P =0.001 ＜ 0.01).The results of AFP-L3％ of 20 HCC patients who underwent operation and therapy showed that the survival rates of AFP-L3％ positive cases at 12 months was 0,and the survival rates of AFP-L3％ negtive cases at 12 months was 15/15.Conclusion The percentage of AFP-L3 has significant clinical values for the early diagnosis of HCC and the operation evaluation of hepatic resection in the patients with low serum AFP level. Key words: Alpha-fetoproteins;  Liver neoplasms;  Diagnosis, differential