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Assessment of KL-6 as a tumor marker in patients with hepatocellular carcinoma

World Journal of Gastroenterology 2005年第42期11卷 6607-6612页

作者： Amal Gad Eiji Tanaka Akihiro Matsumoto Moushira Abd-el Wahab Abd el-Hamid Serwah Fawzy Attia Khalil Ali Howayda Hassouba Abd el-Raoof el-Deeb Tetsuya Ichijyo Takeji Umemura Hidetomo Muto kaname yoshizawa Kendo Kiyosawa Second Department of Internal Medicine Shinshu University School of Medicine Matsumoto Japan Howayda Hassouba Abd el-Raoof el-Deeb Suez Canal University School of Medicine Ismailia Egypt Second Department of Internal Medicine Shinshu University School of Medicine Matsumoto Japan Howayda Hassouba Abd el-Raoof el-Deeb Suez Canal University School of Medicine Ismailia Egypt Shinshu University Graduate School of Medicine Institutes of Organ Transplants Reconstructive Medicine and Tissue Engineering Matsumoto Japan

AIM： To investigate the clinical significance of KL-6 as a tumor marker of HCC in two different ethnic groups with chronic liver disease consecutively encountered at outpatient clinics. METHODS： Serum KL-6 was measured by the sandwich enzyme immunoassay method using the KL-6 antibody （Ab） as both the capture and tracer Ab according to the manufacturer＇s instructions （Eisai, Tokyo, Japan）. Assessment of alpha fetoprotein （AFP） and protein induced vitamin K deficiency or absence （PIVKA-II） was performed in both groups using commercially available kits. RESULTS： A significantly higher mean serum KL-6 （556±467 U/L） was found in HCC in comparison with non-HCC groups either with （391±176 U/L; P〈0.001） or without （361±161 U/L; P〈0.001） liver cirrhosis （LC）. Serum KL-6 level did not correlate with either AFP or PIVKA-II serU/Levels. Using rec：eiver operating curve analysis for KL-6 as a predictor for HCC showed that the area under the curve was 0.574 （95%CI = 0.50-0.64） and the KL-6 level that gave the best sensitivity （61%） was found to be 334 U/L but according to the manufacturer＇s instructions; a cut-off point of 500 U/L was used that showed the highest specificity （80%） in comparison with AFP and PIVKA-II （78% vs 72% respectively）. Combining the values of the three markersimproved specificity of AFP for HCC diagnosis from 78% for AFP alone; 93% for AFP plus PIVKA-II to 99% for both plus KL-6 value （P〈0.001）. Mean serum alkaline phosphatase level was significantly higher in KL-6 positive （564＋475） in comparison with KL-6 negative （505＋469） HCC patients （P = 0.021）, but such a difference was not found among non-HCC corresponding groups. CONCLUSION： KL-6 is suggested as a tumor for HCC. Its positivity may reflect HCC-associated cholestasis and/ or local tumor invasion.

关键词： Tumor markers Liver disease Hepatocellularcarcinoma

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