The Influence of Alcoholic Liver Disease on Serum PIVKA-II Levels in Patients without Hepatocellular Carcinoma.
- Author:
Keunhee KANG
1
;
Ji Hoon KIM
;
Seong Hee KANG
;
Beom Jae LEE
;
Yeon Seok SEO
;
Hyung Joon YIM
;
Jong Eun YEON
;
Jong Jae PARK
;
Jae Seon KIM
;
Young Tae BAK
;
Kwan Soo BYUN
Author Information
- Publication Type:Original Article
- Keywords: Prothrombin induced by vitamin K deficiency or antagonist II; Liver diseases, alcoholic; Hepatocellular carcinoma
- MeSH: Adult; Age Distribution; Aged; Anti-Bacterial Agents/therapeutic use; Aspartate Aminotransferases/blood; Biomarkers/*blood; Carcinoma, Hepatocellular/blood; Diagnosis, Differential; Female; Humans; Liver Cirrhosis/blood; Liver Diseases, Alcoholic/*blood; Liver Neoplasms/blood; Male; Matched-Pair Analysis; Middle Aged; Multivariate Analysis; Protein Precursors/*blood; Prothrombin/analysis; Retrospective Studies; Sex Distribution; gamma-Glutamyltransferase/blood
- From:Gut and Liver 2015;9(2):224-230
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Prothrombin induced by vitamin K deficiency or antagonist II (PIVKA-II) is a widely used diagnostic marker for hepatocellular carcinoma (HCC). We evaluated the correlation between alcoholic liver disease (ALD) and serum PIVKA-II levels in chronic liver disease (CLD) patients. METHODS: We retrospectively reviewed the medical records of 2,528 CLD patients without HCC. Among these patients, 76 exhibited serum high PIVKA-II levels of >125 mAU/mL (group 1). We categorized 76 control patients matched by age, sex, and the presence of liver cirrhosis from the remaining patients who were negative for serum PIVKA-II (group 2). RESULTS: Group 1 revealed increased antibiotic usage (23.7% vs 2.6%, p<0.001) and incidence of ALD (60.5% vs 14.5%, p<0.001) as well as elevated aspartate aminotransferase (52.5 IU/L vs 30.5 IU/L, p=0.025) and gamma glutamyl transpeptidase (67.5 IU/L vs 36.5 IU/L, p=0.005) levels compared with group 2. Further, group 1 was significantly associated with a worse Child-Pugh class than group 2. In the multivariate analysis, ALD (odds ratio [OR], 7.151; p<0.001) and antibiotic usage (OR, 5.846; p<0.001) were significantly associated with positive PIVKA-II levels. CONCLUSIONS: Our study suggests that ALD and antibiotics usage may be confounding factors when interpreting high serum PIVKA-II levels in patients without HCC. Therefore, serum PIVKA-II levels in patients with ALD or in patients administered antibiotics should be interpreted with caution.
