Deyashiki Y, Nishioka Y, Takahashi K, Kosaka Y, Suzuki K
Department of Laboratory Medicine, Mie University School of Medicine, Isu City, Japan.
Cancer. 1989 Dec 15;64(12):2546-51. doi: 10.1002/1097-0142(19891215)64:12<2546::aid-cncr2820641223>3.0.co;2-q.
We measured des-gamma-carboxyglutamic acid prothrombin (protein induced by vitamin K absence or antagonist-Factor II: [PIVKA-II]) in plasmas of normal subjects, patients with thrombotic disease, those with hepatic disease including hepatocellular carcinoma, and those with carcinoma of other tissues, and compared the results with results of blood coagulation tests used for the examination of hepatic function. In addition, in the patients with hepatic disease, PIVKA-II and alpha-fetoprotein (AFP) levels were compared. The PIVKA-II level was frequently high in patients with thrombotic disease given warfarin therapy and those with hepatocellular carcinoma. However, in patients with thrombotic disease who were not given warfarin therapy, no significant correlation was seen between the PIVKA-II value and the results of the thrombotest or hepaplastin test, suggesting no association between the PIVKA-II level and the degree of impairment of hepatic function. In 70 patients with hepatocellular carcinoma, the percentage of patients positive for PIVKA-II (greater than or equal to 0.1 micrograms/ml) and those positive for AFP (greater than or equal to 20 ng/ml) were similar (77% and 74%, respectively). Pearson's correlation of coefficient between the PIVKA-II value and the AFP value in the 70 patients was 0.463. However, false-positive rates in patients with hepatic disease other than hepatocellular carcinoma were lower for PIVKA-II. Combined assessment of PIVKA-II and AFP increased positive rates and allowed exclusion of false-positive patients. The plasma PIVKA-II level is suggested to be useful as an indicator of warfarin control in patients with thrombotic disease, as a marker of hepatocellular carcinoma, and is particularly of value when assessed in combination with AFP.
我们检测了正常受试者、血栓性疾病患者、包括肝细胞癌在内的肝脏疾病患者以及其他组织癌患者血浆中的去γ-羧基谷氨酸凝血酶原（维生素K缺乏或拮抗剂诱导蛋白-因子II：[PIVKA-II]），并将结果与用于肝功能检查的凝血试验结果进行比较。此外，在肝脏疾病患者中，比较了PIVKA-II和甲胎蛋白（AFP）水平。接受华法林治疗的血栓性疾病患者和肝细胞癌患者的PIVKA-II水平经常较高。然而，在未接受华法林治疗的血栓性疾病患者中，PIVKA-II值与血栓试验或肝促凝血酶原激酶试验结果之间未发现显著相关性，这表明PIVKA-II水平与肝功能损害程度之间无关联。在70例肝细胞癌患者中，PIVKA-II阳性（≥0.1微克/毫升）和AFP阳性（≥20纳克/毫升）患者的百分比相似（分别为77%和74%）。70例患者中PIVKA-II值与AFP值之间的Pearson相关系数为0.463。然而，除肝细胞癌外的肝脏疾病患者中PIVKA-II的假阳性率较低。PIVKA-II和AFP联合评估提高了阳性率，并可排除假阳性患者。血浆PIVKA-II水平被认为可作为血栓性疾病患者华法林控制的指标、肝细胞癌的标志物，与AFP联合评估时尤其有价值。
