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ObjectiveTo investigate the value of abnormal prothrombin ［protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)］ in monitoring the short-term efficacy of transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the clinical data of 114 patients with HCC who were admitted to Zhongda Hospital Affiliated to Southeast University from January to December, 2019, and all patients received conventional TACE alone and had a baseline PIVKA-Ⅱ level of ≥40.00 mAU/ml. Serological response of PIVKA-Ⅱ was observed before TACE and at 1, 3, and 6 months after TACE and was compared with radiological response at the same time point (based on mRECIST guidelines). A Spearman correlation analysis was used to investigate the correlation between serological response and radiological response. The paired chi-square test was used to analyze the consistency between the sensitivity of serological response and that of radiological response. Radiological response was used as the gold standard to investigate the validity and reliability assessment indices of the serological response of PIVKA-Ⅱ. ResultsThe patients enrolled in this study had a PIVKA-Ⅱ level of 7225.44 (40.13-30 000.00) mAU/ml. At 1, 3, and 6 months after TACE, 104 patients (91.2%), 94 patients (90.3%), and 86 patients (90.5%), respectively, had serological response, while 103 patients (903%), 90 patients (86.5%), and 82 patients (86.3%) had radiological response. The Spearman correlation analysis showed that radiological response was positively correlated with serological response at 1, 3, and 6 months after TACE (r=0.739, 0.731, and 0.708, all P＜0001). The paired chi-square test showed that serological response and radiological response had a relatively consistent sensitivity in assessment at 1, 3, and 6 months after TACE (χ2=0, 1.5, and 1.5, P=1.000, 0.219, and 0.219). The validity and reliability assessment indices of serological response maintained at a relatively high level. ConclusionBased on the criteria for radiological response, PIVKA-Ⅱ has a good value in monitoring the short-term efficacy of TACE in patients with HCC.
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OBJECTIVE: To evluated the prognostic potential of preoperative PIVKA-Ⅱ and AFP to the patients of HBV infection-related hepatocellular carcinoma(HCC) after radical resection. METHODS: Chronic HBV infection-related HCC patients who undergone resection in the Affiliated Cancer Hospital of Zhengzhou University from 2009 to 2013 with competed data of clinical information,laboratory results and follow-up records were enrolled our study. Finaly, a total of 107 subjects entered our research. PIVKA-Ⅱ was quantitatively measured by Chemiluminescence methods. Kaplan-Meier survival analysis and the Cox proportional hazards model were used to analyze the factors which can affect patient's post surgery survival. RESULTS: Kaplan-Meier survival curve analysis showed that the 1-,2-,3-year survival rate of the patients with high PIVKA-Ⅱ level were 56%, 28% and 16%, respectively, much poor than that of patients with low PIVKA-Ⅱ level, the 1-,2-,3-year survival rate for the latter were 73%, 54% and 46%, respectively(P = 0.002). The 1-,2-,3-year survival rates for patients with high AFP levels were 58%, 35% and 25%, respectively, and the the 1-,2-,3-year survival rates for patients with low AFP levels were 83%, 63% and 51%, respectively(P = 0.006). Multivariate factor results showed that high PIVKA-Ⅱ levels, high AFP levels, the presence of portal vein tumor thrombus and incomplete capsular were independent risk factors for prognosis,HR(95% CI) were 1.99(1.15-3.45), 2.03(110-3.76), 2.72(1.53-4.83) and 2.07(1.07-4.00), respectively. In addition, the prognosis would got worse with the superposition of four independent risk factors. CONCLUSION: Preoperative PIVKA-Ⅱ and AFP levels are associated with HCC patients' s poor post surgery prognosis.
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Objective To explore the performance of serum AFP-L3 and PIVKA-Ⅱ in differential diagnosis of benign and malignant liver disease in high risk population.Methods The serum levels of AFP-L3 and PIVKA-Ⅱ in 48 patients with primary hepatic carcinoma,43 patients with cirrhosis and 81 patients with chronic hepatitis B were analyzed retrospectively.Results There was no statistically different significance among the median levels of serum AFP in primary hepatic carcinoma patients,cirrhosis patients and chronic hepatitis B patients (x2=4.014,P=0.134).Both median level of AFP-L3 and PIVKA-Ⅱ in primary hepatic carcinoma patients were higher than cirrhosis patients and chronic hepatitis B patients (x2 =33.93,52.33,both of P values were below 0.001).The specificity (92.74％) of AFP-L3 and the sensitivity (79.17％) of PIVKA-Ⅱ were all higher.The accuracy (84.88％) of combined detection in series was the highest,with its 47.92％ of sensitivity and 99.19％ of specificity.Conclusion Combined detection PIVKA-Ⅱ and AFP-L3 series will help to differential diagnosis of benign and malignant liver disease in high risk population.
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Objective To investigate the diagnostic value and biological features of protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ) and alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC).Methods Serum samples of 72 patients with HCC (HCC group), 54 patients with hepatitis B cirrhosis (cirrhosis group) and 30 patients with chronic hepatitis B (CHB) without cirrhosis (CHB group) were tested with the PIVKA-Ⅱ and AFP detection kits.Diagnostic efficacies of PIVKA-Ⅱ and AFP were evaluated by receiver-operating characteristic curve (ROC).The cut-off value of PIVKA-Ⅱ for diagnose HCC was also determined.Sensitivities and specificities of PIVKA-Ⅱ and AFP were compared.Results The medians of PIVKA-Ⅱ levels in HCC group, cirrhosis group and CHB group were 14.36, 11.21, and 329.88 mAU/mL, respectively.The serum PIVKA-Ⅱ level in the HCC group was significantly higher than that in cirrhosis group (U=342.50, P0.05).The serum PIVKA-Ⅱ levels in patients with BCLC stage A, B, C in HCC group were 22.13, 345.46, and 13 057.72 mAU/mL, respectively.After comparison of stage A and C with stage B, the differences were both statistically significant (stage A to B: U=119.0, P<0.01;stage B to C: U=158.0, P<0.01).The sensitivity and specificity of PIVKA-Ⅱ with a cut-off value of 30.01 mAU/mL by means of Youden index were 0.750 and 1.000, respectively.When combined PIVKA-Ⅱ with AFP, the sensitivity and specificity were 0.800 and 0.964, respectively.The area under the curve (AUC) was highest (AUC=0.930, 95%CI: 0.852-0.974), and significantly higher than that using PIVKA-Ⅱ alone (AUC=0.892, 95%CI: 0.834-0.950,x2=21.43,P<0.01).Conclusions The diagnostic value of serum PIVKA-Ⅱ is superior to AFP.Combined with AFP, serum PIVKA-Ⅱ can improve the detection rate of HCC, and has advantages during the development of HCC and can be used to monitor the condition of HCC patients.
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Objective To investigate the impact of chronic renal insufficiency on serum levels of protein induced by vitamin K absence or antagonist‐Ⅱ(PIVKA‐Ⅱ) and sialic acid (SA) .MethodsThe levels of serum PIVKA‐Ⅱ ,SA ,urea and creatinine(Cr) were detected in 127 cases of chronic renal insufficiency ,32 cases of renal disease with normal renal function ,57 healthy controls un‐dergoing the physical examination and 120 cases of hepatocellular carcinoma (HCC ) by using the chemiluminescent and enzymatic methods respectively .The serum urea and creatinine levels were also measured .The estimated GFR (eGFR) was calculated .Results The serum PIVKA‐Ⅱ level had no statistical difference in among the healthy control group ,renal disease with normal renal func‐tion group and renal disease with renal insufficiency group (H=2 .902 ,P> 0 .05) ,moreover significantly lower than that in the HCC group (U=319 .5 ,203 .00 ,665 .50 respectively ,P0 .05) .However ,serum SA levels had statistical differences among the healthy control group ,disease complicating normal renal function group and disease complicating renal insufficiency group( H = 63 .685 ,P0 .05) .Conclusion The renal insufficiency has no obvious im‐pact on serum PIVKA‐Ⅱexpression ,but could significantly increase the SA expression level ,moreover is closely related with the se‐verity of renal function impairment ,thus indicating that the SA level increase not only has the assisted diagnosis value on HCC and multiple malignant tumors ,but also better reflects the renal function status in the patients with chronic renal insufficiency .