Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Ann Transplant. 2022 Sep 13;27:e936937. doi: 10.12659/AOT.936937.
BACKGROUND This study analyzed pretransplant alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in liver transplantation (LT) candidates. MATERIAL AND METHODS A total of 3,273 LT recipients enrolled at the Korean Organ Transplantation Registry were divided according to hepatocellular carcinoma (HCC) status and background liver disease, and AFP and PIVKA-II were compared. RESULTS In all patients, the median AFP and PIVKA-II were 6.3 ng/mL and 29 mAU/mL in the viable-HCC group and 3.3 ng/mL and 35 mAU/mL, respectively, in the no-HCC group (P<0.001 for AFP and p=0.037 for PIVKA-II). In patients with hepatitis B virus infection, they were 6.0 ng/mL and 26 mAU/mL in the HCC group and 3.2 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P<0.001). In patients with hepatitis C virus infection, they were 10.7 ng/mL and 37 mAU/mL in the HCC group and 2.6 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.117). In alcoholic liver disease patients, they were 5.2 ng/mL and 61 mAU/mL in the HCC group and 6.4 ng/mL and 75 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.419). In patients with other diseases, they were 7.1 ng/mL and 32 mAU/mL in the HCC group and 3.3 ng/mL and 28 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.822). CONCLUSIONS The results of the present study indicate that pretransplant serum AFP and PIVKA-II were highly variably expressed in LT candidates with end-stage liver diseases; therefore, their values should be cautiously interpreted because their role in HCC diagnosis is limited.
本研究分析了肝移植（LT）候选者移植前甲胎蛋白（AFP）和维生素 K 缺乏或拮抗剂-II（PIVKA-II）诱导的蛋白。
在韩国器官移植登记处登记的 3273 名 LT 受者根据肝细胞癌（HCC）状况和背景肝病进行分组，并比较 AFP 和 PIVKA-II。
在所有患者中，有活力 HCC 组的 AFP 和 PIVKA-II 中位数分别为 6.3ng/ml 和 29mAU/ml，无 HCC 组分别为 3.3ng/ml 和 35mAU/ml（AFP 差异有统计学意义，P<0.001，PIVKA-II 差异有统计学意义，p=0.037）。在乙型肝炎病毒感染者中，HCC 组的 AFP 和 PIVKA-II 中位数分别为 6.0ng/ml 和 26mAU/ml，无 HCC 组分别为 3.2ng/ml 和 21mAU/ml（AFP 和 PIVKA-II 差异均有统计学意义，均 P<0.001）。在丙型肝炎病毒感染者中，HCC 组的 AFP 和 PIVKA-II 中位数分别为 10.7ng/ml 和 37mAU/ml，无 HCC 组分别为 2.6ng/ml 和 21mAU/ml（P<0.001 和 P=0.117）。在酒精性肝病患者中，HCC 组的 AFP 和 PIVKA-II 中位数分别为 5.2ng/ml 和 61mAU/ml，无 HCC 组分别为 6.4ng/ml 和 75mAU/ml（P<0.001 和 P=0.419）。在其他疾病患者中，HCC 组的 AFP 和 PIVKA-II 中位数分别为 7.1ng/ml 和 32mAU/ml，无 HCC 组分别为 3.3ng/ml 和 28mAU/ml（P<0.001 和 P=0.822）。
本研究结果表明，终末期肝病 LT 候选者移植前血清 AFP 和 PIVKA-II 的表达差异很大；因此，应谨慎解释其值，因为它们在 HCC 诊断中的作用有限。
