Zhou XL, Mi YQ, Xu L, Liu YG, Zhong Y, Su ST. Clinical value of protein induced by vitamin K absence or antagonist-II in diagnosis of hepatocellular carcinoma.
Shijie Huaren Xiaohua Zazhi 2018;
26:425-433. [DOI:
10.11569/wcjd.v26.i7.425]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM
To evaluate the clinical value of protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) and alpha-fetoprotein (AFP) in the diagnosis of hepatocellular carcinoma (HCC).
METHODS
A total of 285 patients with HCC, 60 patients with liver cirrhosis, 60 patients with chronic viral hepatitis (38 with chronic hepatitis B and 22 with chronic hepatitis C), 30 patients with other chronic hepatopathies (14 with drug hepatitis, 8 with alcoholic hepatitis, and 8 with non-alcoholic steatohepatitis), 25 patients with gastric cancer or colorectal cancer, and 40 healthy controls were enrolled at the Tianjin Second People's Hospital from April 2016 to April 2017. Their serum samples were collected and serum levels of PIVKA-ⅡandAFP were measured by electrochemiluminescence immunoassay (ELICA). The area under the ROC curve (AUC), sensitivity, and specificity of PIVKA-Ⅱ and AFP, alone or in combination, in the diagnosis of HCC were analyzed. The correlation between PIVKA-Ⅱ and clinical characteristics (such as tumor size and BCLC stage) was also analyzed.
RESULTS
There were significant differences in serum levels of AFP and PIVKA-Ⅱ between the HCC group and the other groups (P < 0.01). Serum levels of both PIVKA-Ⅱ and AFP in the HCC group were significantly higher than those in the other groups (P < 0.01). For the diagnosis of HCC, PIVKA-Ⅱ had a higher sensitivity (84.2% vs 70.9%, P < 0.001) and specificity (81.4% vs 65.6%, P < 0.001) than AFP. When combining the serum levels of AFP and PIVKA-Ⅱ, the sensitivity for the diagnosis of HCC was higher than PIVKA-Ⅱ alone (89.5% vs 84.2%), but there was no statistical significance (P > 0.05). PIVKA-Ⅱ in differentiating HCC cases from controls was also better than AFP (AUC: 0.865 vs 0.768, P < 0.001). In the HCC group, serum levels of PIVKA-Ⅱ were associated with sex, tumor number, and microvascular invasion, but had no association with age, viral infection, tumor diameter, portal vein tumor thrombus, or Child-Pugh classification. Serum levels of PIVKA-Ⅱ increased with increased BCLC stage (H = 48.70, P < 0.001).
CONCLUSION
Serum PIVKA-Ⅱ is more efficient than AFP in the diagnosis of HCC. In the HCC group, PIVKA-Ⅱ serum levels are associated with sex, tumor number, and microvascular invasion.
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