Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2020 Dec;24(24):12675-12685. doi: 10.26355/eurrev_202012_24165.
Hepatocellular carcinoma (HCC) is a primary liver tumor derived from metabolic or viral chronic hepatitis, with few treatment options in advanced cases. New biomarkers that allow improving diagnosis and staging are widely desired. Here, we aim to evaluate the performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) in combination with α-fetoprotein (AFP), in the diagnosis of HCC in patients with metabolic or viral hepatitis.
We enrolled 60 HCC patients (20 metabolic and 40 viral) and 20 healthy subjects (HS) as negative controls. PIVKA-II, AFP, Matrix metalloproteinase-9 (MMP-9) and Fibroblast growth factor (FGF) serum levels were assessed by immunoassays.
AFP and PIVKA-II levels were obviously higher in patients than in HS. AFP displayed a better diagnostic performance than PIVKA-II for viral HCC while PIVKA-II was better for metabolic HCC. The combination of the two biomarkers did not improve the discriminating ability.
PIVKA-II may be considered an independent predictor of macrovascular invasion from HCC cells and it can be used to better stratify HCC patients and should be evaluated in prospective studies for early detection of advanced HCC in metabolic subjects.
肝细胞癌（HCC）是一种源自代谢或病毒性慢性肝炎的原发性肝肿瘤，晚期病例的治疗选择很少。人们广泛希望有新的生物标志物可以改善诊断和分期。在这里，我们旨在评估维生素 K 缺乏或拮抗剂-II 诱导蛋白（PIVKA-II）与甲胎蛋白（AFP）联合在代谢性或病毒性肝炎患者 HCC 诊断中的性能。
我们招募了 60 名 HCC 患者（20 名代谢性和 40 名病毒性）和 20 名健康受试者（HS）作为阴性对照。通过免疫测定评估了血清 PIVKA-II、AFP、基质金属蛋白酶-9（MMP-9）和成纤维细胞生长因子（FGF）的水平。
与 HS 相比，患者的 AFP 和 PIVKA-II 水平明显升高。AFP 对病毒性 HCC 的诊断性能优于 PIVKA-II，而 PIVKA-II 对代谢性 HCC 更好。两种生物标志物的组合并没有提高区分能力。
PIVKA-II 可被视为 HCC 细胞大血管侵犯的独立预测因子，可用于更好地分层 HCC 患者，并应在前瞻性研究中评估其在代谢性患者中早期检测晚期 HCC 的效果。
