Takikawa Y, Suzuki K, Yamazaki K, Goto T, Madarame T, Miura Y, Yoshida T, Kashiwabara T, Sato S
First Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
J Gastroenterol Hepatol. 1992 Jan-Feb;7(1):1-6. doi: 10.1111/j.1440-1746.1992.tb00925.x.
We evaluated the clinical usefulness of a protein induced by vitamin K absence, antagonist-prothrombin (PIVKA-II), in detecting hepatocellular carcinoma (HCC) specifically in patients with liver cirrhosis, and the possible correlation between levels of PIVKA-II and pathological features of HCC. Plasma levels of PIVKA-II and alpha-fetoprotein (AFP) were measured in 628 patients with various diseases, including 253 with liver cirrhosis and 116 with HCC. PIVKA-II was detected (greater than or equal to 0.1 arbitrary unit/mL) in 54.3% of HCC and the concentration showed a positive correlation with the tumour size. As a screening test for the detection of HCC, PIVKA-II produced values comparable with those of AFP with a sensitivity, specificity and validity of 52.8, 98.8 and 51.6% respectively. Sixteen of 45 patients (37%) with HCC who had low AFP (less than 100 ng/mL) levels were positive for PIVKA-II. No apparent relationship, however, could be found between the levels of PIVKA-II and the aetiology or pathological findings of HCC. These results suggest that PIVKA-II can be a reliable marker for detecting HCC in patients with liver cirrhosis.
我们评估了维生素K缺乏诱导蛋白-抗凝血酶原（PIVKA-II）在检测肝硬化患者肝细胞癌（HCC）方面的临床实用性，以及PIVKA-II水平与HCC病理特征之间的可能相关性。对628例患有各种疾病的患者检测了血浆中PIVKA-II和甲胎蛋白（AFP）的水平，其中包括253例肝硬化患者和116例HCC患者。54.3%的HCC患者检测到PIVKA-II（大于或等于0.1任意单位/毫升），且其浓度与肿瘤大小呈正相关。作为检测HCC的筛查试验，PIVKA-II的检测值与AFP相当，其敏感性、特异性和有效性分别为52.8%、98.8%和51.6%。45例AFP水平较低（小于100 ng/mL）的HCC患者中有16例（37%）PIVKA-II呈阳性。然而，未发现PIVKA-II水平与HCC的病因或病理结果之间存在明显关系。这些结果表明，PIVKA-II可以作为检测肝硬化患者HCC的可靠标志物。
