The diagnostic value of PIVKA-Ⅱcombined with AFP and AST/ALT ratio in the diagnosis of primary liver cancer with HBV infection / 国际检验医学杂志

ABSTRACT

Objective To investigate the expression level of protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in serum of primary liver cancer patients with HBV infection and combined with alphafetoprotein (AFP) and AST/ALT ratio in the diagnosis of primary liver cancer with HBV infection.Methods Sera of 68 HBV infection patients with primary liver cancer were collected.Meanwhile, sera of 109 HBV infection patients (8 cases of gallbladder diseases, 94 cases of benign liver diseases, 7 csaes of other organ diseases) were collected as controls.The serum levels of PIVKA-Ⅱand AFP were detected by the method of chemiluminescent immunoassay and electrochemical luminescence respectively.The rate method was used to detect the content of AST and ALT, and the ratio of AST/ALT was calculated.Compared the expression level of tumor markers in each group, and the receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic efficacy of individual and combined application of each index in the diagnosis of primary liver cancer.Results The sera levels of PIVKA-Ⅱ, AFP and AST/ALT ratio in primary liver cancer with HBV infection group were all higher than those in control group (P＜0.01).ROC curve analysis showed that with the critical value of PIVKA-Ⅱ, AFP and AST/ALT ratio in serum were 100.42 mAu/mL, 232.35 ng/mL and 1.571 in the diagnosis of primary liver cancer with HBV infection, the area under the ROC curve (AUC) were 0.942, 0.786 and 0.723 respectively;the sensitivity were 89.70％, 58.80％and 51.50％;the specificity were 91.70％, 88.10％and 79.80％.The AUC of PIVKA-Ⅱcombined with AST/ALT ratio in the diagnosis of primary liver cancer with HBV infection was 0.955, the sensitivity and specificity wree 86.80％and 93.40％respectively.Conclusion The value of PIVKA-II in the diagnosis of primary liver cancer with HBV infection is obviously better than that of AFP and AST/ALT ratio.The combined detection with AST/ALT ratio will be helpful to improve the diagnostic efficacy of primary liver cancer with HBV infection.