Title |
Diagnostic value of prothrombin induced by the absence of vitamin K or antagonist-II (PIVKA-II) for early stage HBV related hepatocellular carcinoma
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Published in |
Infectious Agents and Cancer, August 2017
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DOI | 10.1186/s13027-017-0153-6 |
Pubmed ID | |
Authors |
Xiumei Wang, Weiwei Zhang, Youde Liu, Wenjing Gong, Ping Sun, Xiangshuo Kong, Miaomiao Yang, Zhihua Wang |
Abstract |
To evaluate the diagnostic efficacy of prothrombin induced by the absence of vitamin K or antagonist-II (PIVKA-II) for early stage hepatitis virus B (HBV) related hepatocellular carcinoma (HCC). Serums levels of PIVKA-II and a-Fetoprotein (AFP) was detected and compared in 113 patients with clinical confirmed Barcelona Clinic Liver Cancer (BCLC) stage 0-A HBV-related HCC and 161 chronic hepatitis B (CHB) patients. Diagnostic efficiencies as well as cut-off values of PIVKA-II, AFP and combination of the two markers were calculated using receiver operator curve (ROC) analysis. The mean level of PIVKA-II among HCC patients were 79.64 ± 149.88, significantly higher than control group (P < 0.001). ROC results showed that among those AFP-negative HCC patients, the area under ROC curve (AUROC) of PIVKA-II was 0.73 (95%CI 0.640-0.815, P < 0.001). Among HCC patients diagnosed with small HCC (tumor size ≤2 cm), the AUROC of PIVKA- II was 0.692 (95%CI 0.597-0.788, P < 0.001). To evaluate the diagnostic value of PIVKA-II in HCC patient, all CHB cases were pooled together as control for analysis. The AUROC of PIVKA-II was 0.756 (95%CI 0.698-0.814, P < 0.001), and the optimal cutoff value of PIVKA-II was 32.09 mAU/ml with sensitivity of 52.21% and specificity of 81.49%. When serum levels of PIVKA-II and AFP were combined to obtain a new marker for HCC diagnosis, PIVKA-II + AFP further increased diagnostic efficiency, with AUROC of 0.868 (95%CI 0.822-0.913), higher than that of AFP (P < 0.01) or PIVKA-II (P < 0.001) alone. In addition, we found that HCC patients in poorly differentiated- undifferentiated group and in microvascular invasion group had higher levels of PIVKA-II. Multivariate analysis showed that high serum PIVKA-II level (OR = 1.003, 95%CI 1.001-1.007, P = 0.047) was an independent risk factor for microvascular invasion in HCC patients. Serum PIVKA-II level is a potential marker for early diagnosis of HCC and microvascular invasion. The use of PIVKA-II may improve assessment of tumor prognosis and guide development of therapeutic strategy. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 21 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 3 | 14% |
Student > Postgraduate | 3 | 14% |
Student > Ph. D. Student | 2 | 10% |
Other | 2 | 10% |
Researcher | 2 | 10% |
Other | 1 | 5% |
Unknown | 8 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 3 | 14% |
Biochemistry, Genetics and Molecular Biology | 2 | 10% |
Chemistry | 2 | 10% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
Immunology and Microbiology | 1 | 5% |
Other | 3 | 14% |
Unknown | 9 | 43% |