@article{oai:niigata-u.repo.nii.ac.jp:00008771,
 author = {青柳, 豊},
 issue = {1},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Jan},
 note = {The quantitative determinations of AFP (alpha-fetoprotein) has been extensively used for the detection of HCC (hepatocellular carcinoma). However, the serum concentration of AFP also increases moderately in nonneoplastic liver diseases. Moreover, the serum concentrations of AFP in HCC at the time of initial diagnosis became lower recently owing to the advancement of imaging modalities. Accordingly, these clinical circumstances lead to molecular discrimination of AFP between HCC and benign liver diseases by taking advantage of the reactivity of AFP with various lectins. LCA-reactive species of AFP was significantly greater in HCC than benign liver diseases. Molecular basis of this variation is the fucosylation of sugar chain at innermost N-acetylglucosamine residue. On the other hand, Con A-nonreactive species of AFP was significantly higher in AFP-producing gastrointestinal carcinoma than HCC and benign liver diseases. Molecular basis of Con A-nonreactive variants is the N-acetylglucosaminylation of the mannose residue at the trimannosyl core although the position to be modified is different. Therefore, the terms "fucosylation index, that is L3 fraction and glucosaminylation indices" were adopted to express the percentages of LCA-reactive and Con A-nonreactive species of AFP, respectively. These indices are beneficial to the detection of HCC even if it is early stage. Furthermore, L3 from the sera before the initial treatment serves as a new prognostic factor and improves prognostic estimates and appraisal of therapeutic outcome in patients with HCC. Accordingly, not only quantitative but also qualitative measurements of AFP provide us very valuable information in the differential diagnosis of various liver diseases and the estimation of therapeutic outcome in patients with HCC.},
 pages = {1--9},
 title = {腫瘍マーカーによる肝癌診断 ・治療戦略 AFP糖鎖変異を中心に（最終講義）},
 volume = {129},
 year = {2015}
}