Department of Hepatic Surgery, Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
Sci Rep. 2024 Apr 10;14(1):8416. doi: 10.1038/s41598-024-59174-5.
Protein induced by vitamin K absence or antagonist II (PIVKA-II) plays a critical role in the diagnosis of hepatocellular carcinoma (HCC), however, studies on its efficacy in diagnosing recurrent HCC were rarely found. A multicenter, retrospective, and observational study was conducted. During the overall follow-up of 5 years, HCC patients who had curative resection were monitored every 3 months in the first year post-surgery and every 6 months thereafter if no recurrence occurred. Tumor markers were collected at the diagnosis of recurrence for those with recurrence and at the last follow-up for those without recurrence. The median serum levels of PIVKA-II and AFP in the recurrence group were significantly higher than those in the non-recurrence group (PIVKA-II: 84.62 vs. 18.76 mAU/ml, p < 0.001; AFP: 4.90 vs. 3.00 ng/ml, p < 0.001) and there is a significant correlation between PIVKA-II and AFP (R = 0.901, p < 0.001). PIVKA-II showed better accuracy than AFP in the diagnosis of overall recurrent HCC (AUC: 0.883 vs. 0.672; p < 0.0001), but also in patients with negative PIVKA-II before curative resection (AUC: 0.878 vs. 0.680, p = 0.001). Clinician should pay more attention to serum PIVKA-II values when following patients after curative HCC resection to detect early recurrence.Clinical trial registration: ChiCTR2300070874.
维生素 K 缺乏或拮抗剂 II 诱导蛋白（PIVKA-II）在肝细胞癌（HCC）的诊断中起着关键作用，然而，关于其在诊断复发性 HCC 中的功效的研究很少。一项多中心、回顾性、观察性研究。在 5 年的总体随访中，对接受根治性切除术的 HCC 患者进行监测，术后第 1 年每 3 个月监测一次，如果没有复发，则此后每 6 个月监测一次。对于有复发的患者，在诊断复发时收集肿瘤标志物，对于没有复发的患者，在最后一次随访时收集肿瘤标志物。复发组的血清 PIVKA-II 和 AFP 中位水平明显高于无复发组（PIVKA-II：84.62 与 18.76 mAU/ml，p<0.001；AFP：4.90 与 3.00 ng/ml，p<0.001），且 PIVKA-II 与 AFP 之间存在显著相关性（R=0.901，p<0.001）。在诊断总体复发性 HCC 方面，PIVKA-II 比 AFP 具有更好的准确性（AUC：0.883 与 0.672；p<0.0001），但在根治性切除术前 PIVKA-II 阴性的患者中也是如此（AUC：0.878 与 0.680，p=0.001）。临床医生在对接受根治性 HCC 切除术后的患者进行随访时，应更加关注血清 PIVKA-II 值，以检测早期复发。临床试验注册：ChiCTR2300070874。
