Gentile Ivan, Buonomo Antonio Riccardo, Scotto Riccardo, Zappulo Emanuela, Carriero Canio, Piccirillo Mauro, Izzo Francesco, Rizzo Marianna, Cerasuolo Dionigio, Borgia Guglielmo, Cavalcanti Ernesta
Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
In Vivo. 2017 Jul-Aug;31(4):695-700. doi: 10.21873/invivo.11115.
BACKGROUND/AIM: Patients affected by liver cirrhosis are at high risk for developing hepatocellular carcinoma (HCC). The aim of this study was to evaluate the feasibility of PIVKA-II (protein induced by vitamin K absence or antagonist-II) alone or in combination with α-1 fetoprotein (AFP), as a screening marker for development of HCC.
A case-control study was conducted in 2 hospital wards in Naples. All anti-HCV-positive patients affected by HCC were considered as cases, while consecutive anti-HCV-positive patients without HCC were considered as controls.
Overall, 160 patients were enrolled, 56 cases and 104 controls. At the set cut-off of 36 mAU/ml, PIVKA-II was more sensitive (78.6% vs. 60%), but less specific than AFP at the set cut-off of 12 ng/ml (66.3% vs. 77.2%). The negative predictive value of PIVKA in combination with AFP was 93.2%.
PIVKA II, when combined with AFP, may be considered as a screening test for HCC due to its high negative predictive value.
背景/目的：肝硬化患者发生肝细胞癌（HCC）的风险很高。本研究的目的是评估单独使用异常凝血酶原（PIVKA-II，即维生素K缺乏或拮抗剂-II诱导蛋白）或与甲胎蛋白（AFP）联合作为HCC发生的筛查标志物的可行性。
在那不勒斯的2个医院病房进行了一项病例对照研究。所有抗丙型肝炎病毒（HCV）阳性且患有HCC的患者被视为病例，而连续的抗HCV阳性且无HCC的患者被视为对照。
总共招募了160名患者，56例病例和104名对照。在设定的36 mAU/ml临界值时，PIVKA-II更敏感（78.6%对60%），但在设定的12 ng/ml临界值时比AFP特异性更低（66.3%对77.2%）。PIVKA与AFP联合的阴性预测值为93.2%。
PIVKA II与AFP联合时，因其高阴性预测值，可被视为HCC的一种筛查试验。
