Simultaneous determination of alpha-fetoprotein immune complexes and alpha-fetoprotein concentration in hepatocellular carcinoma using dual-label time-resolved immunofluorometric assays

Simultaneous detection of Mycoplasma pneumoniae IgG and IgM using dual-label time resolved fluoroimmunoassay

Anti-Mycoplasma pneumoniae (MP) IgM and IgG are useful serological markers for detection of MP infection. In this study, a simultaneous quantification of MP IgM and IgG was performed by time-resolved fluoroimmunoassay (TRFIA). The europium-labeled anti-human IgM and samarium-labeled anti-human IgG were used as tracers, and MP IgM and IgG were recognized in serum samples. After dissociating europium and samarium ions from the immune complex, their fluorescence intensity was recorded and used to calculate the concentrations. The linear range and sensitivity of detection were 2-5500 BU/mL and 0.5 BU/mL for IgM, and 1.5-1500 BU/mL and 0.2 BU/mL for IgG, respectively. The intra- and inter-assay coefficients of variation were 5.14% and 8.41% for IgM, and 5.44% and 8.76% for IgG, respectively. The recovery rate was 94.9-106.8% for IgM and 96.1-109.4% for IgG. The correlation rates of serum detection for 38 respiratory infected patients between dual-label TRFIA and ELISA were 0.9294 and 0.9366 for IgM and IgG, respectively. The coincidence rate between passive particle agglutination and TRFIA is 93.3%. Dual-label TRFIA is a sensitive and reliable technique for measuring MP IgM and IgG levels and could be useful for the early diagnosis of MP infection.

Diagnostic and prognostic role of SCCA-IgM serum levels in hepatocellular carcinoma (HCC)

BACKGROUND AND AIM

The serpin squamous cell carcinoma antigen complexed with IgM (SCCA-IgM) has been reported as a promising serological marker for hepatocellular carcinoma (HCC). We aimed to further evaluate SCCA-IgM diagnostic accuracy and to determine its prognostic role.

METHODS

SCCA-IgM levels were determined in 327 sera obtained from 81 HCC patients, 206 cirrhotics and 40 healthy blood donors (controls). Sensitivity, specificity, correlation with clinical and tumor parameters and with survival were evaluated.

RESULTS

HCC patients had SCCA-IgM levels significantly higher than controls and cirrhotics (P < 0.0001). Sensitivity, specificity, positive and negative predictive values for HCC were 89%, 50%, 41% and 92%, respectively. In comparison, sensitivity and specificity for alphafetoprotein were 48% and 85%. SCCA-IgM levels were not significantly correlated with clinical or biological variables. With a cut-off of 130 AU/mL (receiver operating characteristic curves), SCCA-IgM proved efficient in the prediction of prognosis, identifying the patients with long overall survival (efficiency validated in the homogenous subgroup of patients with intermediate-stage HCC undergoing transarterial chemoembolization) and predicting progression-free survival. A Cox multivariate analysis confirmed SCCA-IgM predictive value, identifying tumor size and SCCA-IgM levels as independent predictors of survival. A reduction in SCCA-IgM levels correlated with response to treatment.

CONCLUSIONS

SCCA-IgM is a sensitive marker of HCC in patients with cirrhosis even though lacking in specificity. The determination of the levels of the marker in HCC patients is highly efficient in predicting the patients' prognosis, identifying those with long overall and progression-free survival and the responders and should be introduced in the clinical practice.

Lens culinaris agglutinin-reactive α-fetoprotein decline after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma predicts survival

BACKGROUND

Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3) is a fucosylated fraction of AFP that is highly specific for hepatocellular carcinoma (HCC). We studied the relationship between AFP-L3 response and treatment outcome in terms of radiologic response and overall survival in patients undergoing transcatheter arterial chemoembolization (TACE).

METHODS

We retrospectively analyzed 152 patients with advanced HCC undergoing TACE. Serum AFP-L3 and AFP levels were measured simultaneously with a novel lectin dual-label time-resolved immunofluorometric assay (lectin dual-label TRFIA). AFP-L3 response was defined as a ≥20% reduction in AFP-L3 level after a minimum of 2 cycles of chemotherapy.

RESULTS

A total of 47 AFP-L3 responders had improved median overall survival of 42.9 months compared with 15.4 months in nonresponders (P<0.0001), and AFP-L3 response was strongly associated with radiologic response (P<0.0001). The combination of AFP-L3 response and serum AFP response provided further prognostic information. On multivariate analysis, the prognostic value of AFP-L3 response was independent of maximum tumor diameter and BCLC stage.

CONCLUSION

A significant reduction in AFP-L3 in patients with advanced HCC is an important predictor of survival. Achieving an AFP-L3 response should be one of the therapeutic intents of TACE.

Clinical application of serum alpha-fetoprotein-IgM complexes on the diagnosis of primary hepatocellular carcinoma in Kazakh and Han populations

Aims and background

We detected serum AFP-IgM levels in patients with primary hepatocellular carcinoma in Kazakh and Han populations to investigate the clinical significance of AFP-IgM in the diagnosis of hepatocellular carcinoma.

Methods and study design

Serum AFP-IgM levels were examined in 28 cases of hepatocellular carcinoma and 164 controls in the Kazakh population and in 85 cases of hepatocellular carcinoma and 187 controls in the Han population. AFP-IgM was detected with the ELISA assay.

Results

In general, serum AFP-IgM levels of hepatocellular carcinoma patients in the Han population and hepatocellular carcinoma patients in the Kazakh population were statistically higher than those of controls, but there was no statistical significance between hepatocellular carcinoma patients in the Han and hepatocellular carcinoma patients in the Kazakh population.

Conclusions

AFP-IgM is an encouraging serological marker and may be useful in the diagnosis of hepatocellular carcinoma.

Dual-label time-resolved fluoroimmunoassay for simultaneous quantification of haptoglobin and C-reactive protein in meat juice from pigs

A new method was developed to simultaneously measure 2 acute-phase proteins (APPs) by time-resolved immunofluorometry. The assay, based on double-label quantification of haptoglobin (Hp) and C-reactive protein (CRP) in meat juice samples from pigs, was constructed by use of a combination of europium and samarium chelate lanthanides as labels. Meat juice samples from 154 pigs were used for analytic and clinical validation of the assay through determination of precision, accuracy, limit of detection, and quantification. The analytic performance of the assay was satisfactory, with good intra-assay and interassay precision and accuracy. The levels of Hp and CRP were increased in the meat juice samples of diseased animals compared with healthy ones. According to the results, higher sensitivity could be achieved if the cut-off values of both proteins were taken into account for clinical relevance rather than used individually. Since the dual assay saved both time and sample, it could be used as a rapid and sensitive screening test in porcine production.