Serum AFP and AFP-L3 in Clinically Distinguished Hepatocellular Carcinoma from Patients with Liver Masses
Somboon Subwongcharoen MD, MSc*, Kawin Leelawat MD, PhD*, Sa-ard Treepongkaruna MD*, Siriluck Narong MSc**
Affiliation : * Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand ** Division of Research and Technology Assessment, Rajavithi Hospital, Bangkok, Thailand
Objective : To determine the ability of alpha fetoprotein (AFP) and AFP-L3% serum level in discriminating hepatocellular
carcinoma (HCC) from other types of liver mass.
Material and Method: This study was performed according to a prospective-specimen-collection, retrospective-blinded-
evaluation (PRoBE) design. A total of 109 HCC patients and 51 patients with other types of liver mass were consecutively
selected. The levels of AFP and AFP-L3% in their sera were measured.
Results : AFP levels in serum significantly elevated while AFP-L3% levels significantly decreased in HCC patients (AFP: p <
0.001, AFP-L3%: p < 0.001). The area under the curve (AUC) of a receiver operating characteristic (ROC) curve analysis
for the diagnosis of HCC of AFP and AFP-L3% was 0.71 and 0.67, respectively. In addition, the serum level of AFP-L3% was
significantly different between the small (mass occupying lesser than 50% of liver volume) and large (mass occupying more
than 50% of liver volume) HCC (p = 0.040).
Conclusion : The diagnostic accuracy of serum AFP and AFP-L3% could provide them as candidate biomarkers to discriminate
patients with HCC from patients with other types of liver mass. Serum AFP-L3% as a prognostic factor for HCC should be
further evaluated in more details.
Keywords : AFP, AFP-L3%, Hepatocellular carcinoma
