Sakon M, Monden M, Goto M, Kanai T, Umeshita K, Endo W, Mori T
Second Department of Surgery, Osaka University Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1990 May;91(5):588-93.
The changes in the plasma level of PIVKA-II (Protein Induced by Vitamin K Absence or Antagonist-II) following the treatment or progress of the disease was studied in 60 patients with hepatocellular carcinoma. The positivity rate determined by the changes in PIVKA-II was 58.4 percent (35/60 cases) and was about the same as those reported so far, all of which were obtained by a single determination of PIVKA-II. Plasma PIVKA-II was elevated in 61.9 percent (13/21 cases) of alpha-fetoprotein negative patients and it was almost identical with the overall positivity rate. In parallel with serum alpha-fetoprotein, the plasma level of PIVKA-II was decreased after the surgery or transcatheter arterial embolization and was increased when the recurrence or progress of the disease was observed. Furthermore, the nonspecific elevation of PIVKA-II due to the associated liver cirrhosis or chronic hepatitis was infrequent compared with that of alpha-fetoprotein. In 18 cases positive with both PIVKA-II and alpha-fetoprotein, a close correlation (R = 0.91) was observed between the changes of these markers during the progress or treatment of the disease. Thus, it was suggested that determination of PIVKA-II in blood might be useful not only in the diagnosis but in monitoring the progress or the effectiveness of treatments in hepatocellular carcinoma.
对60例肝细胞癌患者研究了疾病治疗或进展过程中异常凝血酶原（维生素K缺乏或拮抗剂-II诱导蛋白）血浆水平的变化。由异常凝血酶原变化所确定的阳性率为58.4%（35/60例），与迄今报道的结果大致相同，这些报道均通过单次测定异常凝血酶原获得。在甲胎蛋白阴性的患者中，61.9%（13/21例）的患者血浆异常凝血酶原升高，这与总体阳性率几乎相同。与血清甲胎蛋白一样，手术后或经动脉导管栓塞后血浆异常凝血酶原水平下降，而在观察到疾病复发或进展时则升高。此外，与甲胎蛋白相比，因合并肝硬化或慢性肝炎导致的异常凝血酶原非特异性升高并不常见。在18例异常凝血酶原和甲胎蛋白均为阳性的病例中，观察到疾病进展或治疗期间这些标志物变化之间存在密切相关性（R = 0.91）。因此，提示血液中异常凝血酶原的测定不仅对肝细胞癌的诊断有用，而且对监测疾病进展或治疗效果也有用。
