Truong Bui Xuan, Yano Yoshihiko, VAN Vu Tuong, Seo Yasushi, Nam Nguyen Hoai, Trach Nguyen Khanh, Utsumi Takako, Azuma Takeshi, Hayashi Yoshitake
Vinmec International Hospital; ; Department of Gastroenterology;
Department of Gastroenterology; ; Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan ;
Biomed Rep. 2013 Jan;1(1):122-128. doi: 10.3892/br.2012.4. Epub 2012 Aug 24.
Hepatitis B virus (HBV) is a leading cause of hepatocellular carcinoma (HCC). α-fetoprotein (AFP) is a common tumor marker for the diagnosis of HCC, although not for protein induced by the absence of vitamin K or antagonist-II (PIVKA-II). The present study aimed to evaluate the role of PIVKA-II in the diagnosis of HCC in HBV-infected Vietnamese patients. A total of 166 consecutive HBV-infected Vietnamese patients were enrolled, including 41 HCC, 43 liver cirrhosis (LC), 26 chronic hepatitis (CH) and 56 asymptomatic carriers (ASC). AFP was examined using ELISA, while PIVKA-II was analyzed using Eitest PIVKA-II. The cut-off level of AFP and PIVKA-II was 20 ng/ml and 40 mAU/ml, respectively. Although the markers, AFP (344±356 ng/ml) and PIVKA-II (16,200±25,386 mAU/ml), were the highest in the HCC groups, only PIVKA-II in HCC was significantly higher compared to the other groups (P<0.001). The univariate analysis demonstrated that age over 50, male, genotype C, AFP and PIVKA-II were risk factors of LC and HCC. Results of the receiver operating characteristics (ROC) analysis showed that PIVKA-II was more sensitive to HCC compared to AFP. Moreover, PIVKA-II was strongly correlated with the portal venous thrombosis in HCC, as opposed to AFP. Results of the multivariate analysis demonstrated that PIVKA-II was the strongest independent risk factor of LC and HCC. In conclusion, PIVKA-II is likely to be a better marker for the diagnosis of HCC in chronic HBV-infected Vietnamese patients.
乙型肝炎病毒（HBV）是肝细胞癌（HCC）的主要病因。甲胎蛋白（AFP）是诊断HCC的常见肿瘤标志物，不过并非是维生素K缺乏或拮抗剂-II诱导蛋白（PIVKA-II）。本研究旨在评估PIVKA-II在越南HBV感染患者HCC诊断中的作用。共纳入166例连续的越南HBV感染患者，包括41例HCC、43例肝硬化（LC）、26例慢性肝炎（CH）和56例无症状携带者（ASC）。采用酶联免疫吸附测定法检测AFP，同时使用Eitest PIVKA-II分析PIVKA-II。AFP和PIVKA-II的临界值分别为20 ng/ml和40 mAU/ml。尽管AFP（344±356 ng/ml）和PIVKA-II（16,200±25,386 mAU/ml）在HCC组中最高，但只有HCC组的PIVKA-II显著高于其他组（P<0.001）。单因素分析表明，年龄超过50岁、男性、C基因型、AFP和PIVKA-II是LC和HCC的危险因素。受试者工作特征（ROC）分析结果显示，与AFP相比，PIVKA-II对HCC更敏感。此外，与AFP不同，PIVKA-II与HCC中的门静脉血栓形成密切相关。多因素分析结果表明，PIVKA-II是LC和HCC最强的独立危险因素。总之，PIVKA-II可能是慢性HBV感染越南患者HCC诊断的更好标志物。
