Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Chemistry Department, Faculty of Science, Mansoura University, Mansoura, Egypt.
J Adv Res. 2013 Nov;4(6):539-46. doi: 10.1016/j.jare.2012.10.004. Epub 2013 Jan 11.
Liver cancer grows silently with mild or no symptoms until advanced. In the absence of an effective treatment for advanced stage of hepatic cancer hope lies in early detection, and screening for high-risk population. Among Egyptians viral hepatitis is the most common risk factor for hepatocellular carcinoma (HCC). The current work was designed to determine the level of prothrombin induced by vitamin K absence-II (PIVKA-II) in sera of patients suffering from HCC and hepatitis C virus (HCV) patients being the most common predisposing factor for HCC. Our ultimate goal is diagnosis of HCC at its early stage. The current study was carried out on 83 individuals within three groups; Normal control, HCV and HCC groups. Patients were subdivided into cirrhotic and non-cirrhotic. Complete clinicopathological examination was carried out for each individual to confirm diagnosis. Individuals' sera were subjected to quantitative determination of alpha-fetoprotein (AFP), PIVKA-II and other parameters. PIVKA-II proved to be superior to AFP for early detection of HCC patients being highly sensitive and specific. Furthermore it has the ability to discriminate between different histopathological grades of HCC and It has a powerful diagnostic validity to evaluate the thrombosis of portal vein and to differentiate between early and late stages of HCC. The direct relation between the level of PIVKA-II and the size of tumor makes it an attractive tool for early HCC diagnosis and surveillance. Using the best cut-off value of AFP (>28), showed a sensitivity of (44%) and specificity of (73.3%). While cut-off value of PIVKA-II (>53.7) showed 100% sensitivity and specificity.
肝癌在进展期之前通常无症状或症状轻微，且生长较为隐匿。对于晚期肝癌，目前尚无有效的治疗方法，因此早期发现和高危人群筛查是治疗的关键。在埃及，病毒性肝炎是导致肝细胞癌（HCC）的最常见危险因素。本研究旨在检测维生素 K 缺乏诱导的凝血酶原（PIVKA-II）在 HCC 和丙型肝炎病毒（HCV）患者血清中的水平，这两种疾病是导致 HCC 的最常见诱因。我们的最终目标是在疾病早期诊断 HCC。本研究共纳入 83 名研究对象，分为三组：正常对照组、HCV 组和 HCC 组。根据有无肝硬化，将患者进一步分为肝硬化组和非肝硬化组。对每位研究对象进行完整的临床病理检查以明确诊断。检测每位研究对象的血清样本中 AFP、PIVKA-II 等参数的水平。结果表明，与 AFP 相比，PIVKA-II 对 HCC 患者的早期检测更具优势，具有更高的敏感性和特异性。此外，PIVKA-II 能够区分不同组织学分级的 HCC，具有较强的诊断有效性，可评估门静脉血栓形成，区分 HCC 的早期和晚期。PIVKA-II 水平与肿瘤大小直接相关，使其成为早期 HCC 诊断和监测的一种有吸引力的工具。使用 AFP 的最佳截断值（>28），其敏感性为（44%），特异性为（73.3%）。而 PIVKA-II 的截断值（>53.7）具有 100%的敏感性和特异性。
