Cancer Biomark. 2018;23(2):235-242. doi: 10.3233/CBM-181402.
It is reported that prothrombin induced by vitamin K absence-II (PIVKA-II) has a better performance of diagnosis for HCC, and has also been known to be an independent risk factor for vascular invasion. Few studies study the relationship between PIVKA-II and HBV DNA.
To determine the clinical value of serum Prothrombin induced by vitamin K absence-II (PIVKA-II) in early hepatocellular carcinoma (HCC), and to explore its relationship with vascular invasion and HBV DNA.
In a Chinese cohort, we conducted a case-control study to compare the performances of a-fetoprotein (AFP) and PIVKA-II serum levels for diagnosis of HCC and early HCC. Fifty one healthy controls, 37 chronic hepatitis patients, 43 cirrhotic patients and 143 HCC cases of which 48 (33.57%) had early stage HCC (n= 19 very early, n= 29 early) were enrolled. We explored the correlation between PIVKA-II serum level and several pathological features such as vascular invasion. The serum levels of and AFP were measured by chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLA).
The serum levels of both PIVKA-II and AFP in HCC group were higher than that in chronic hepatitis, cirrhosis and healthy control groups. The sensitivity, specificity, positive predictive value, negative predictive value and kappa of PIVKA-II were higher than AFP in the diagnosis of HCC. Serum PIVKA-II level was correlated with tumor size, tumor cell differentiation and BCLC staging (P< 0.05). For the diagnosis of early HCC, the combination of PIVKA-II (AUC 0.812; 95% CI, 0.702-0.894) and AFP (0.797; 95% CI, 0.686-0.883) slightly improve the diagnostic performance for early HCC(AUC 0.849; 95% CI, 0.745-0.923). PIVKA-II > 166 mAU/ml is an independent risk factor for vascular invasion. The serum HBV DNA level in cirrhosis and HCC patients was significantly higher than in chronic hepatitis patients. We detected a negative association between serum PIVKA-II and serum HBV DNA levels.
PIVKA-II was more efficient than AFP for the diagnosis of early HCC and has no correlation with serum HBV DNA levels.
据报道，维生素 K 缺乏诱导的凝血酶原（PIVKA-II）对 HCC 的诊断性能更好，并且已经被认为是血管侵犯的独立危险因素。很少有研究研究 PIVKA-II 与 HBV DNA 的关系。
确定血清 Prothrombin 诱导的维生素 K 缺乏-II（PIVKA-II）在早期肝细胞癌（HCC）中的临床价值，并探讨其与血管侵犯和 HBV DNA 的关系。
在中国队列中，我们进行了一项病例对照研究，比较了甲胎蛋白（AFP）和 PIVKA-II 血清水平对 HCC 和早期 HCC 的诊断性能。纳入 51 名健康对照者、37 名慢性肝炎患者、43 名肝硬化患者和 143 名 HCC 患者，其中 48 例（33.57%）为早期 HCC（n=19 例非常早期，n=29 例早期）。我们探讨了 PIVKA-II 血清水平与血管侵犯等多种病理特征之间的相关性。AFP 和 PIVKA-II 血清水平采用化学发光法（CLIA）和电化学发光法（ECLA）进行测量。
HCC 组的 PIVKA-II 和 AFP 血清水平均高于慢性肝炎、肝硬化和健康对照组。在 HCC 的诊断中，PIVKA-II 的灵敏度、特异性、阳性预测值、阴性预测值和kappa 值均高于 AFP。血清 PIVKA-II 水平与肿瘤大小、肿瘤细胞分化和 BCLC 分期相关（P<0.05）。对于早期 HCC 的诊断，PIVKA-II（AUC 0.812；95%CI，0.702-0.894）和 AFP（0.797；95%CI，0.686-0.883）的联合使用略改善了早期 HCC 的诊断性能（AUC 0.849；95%CI，0.745-0.923）。PIVKA-II>166 mAU/ml 是血管侵犯的独立危险因素。肝硬化和 HCC 患者的血清 HBV DNA 水平明显高于慢性肝炎患者。我们检测到血清 PIVKA-II 与血清 HBV DNA 水平之间呈负相关。
PIVKA-II 对早期 HCC 的诊断效率优于 AFP，与血清 HBV DNA 水平无关。
