Clinical application of serum PIVKA-Ⅱ level in the diagnosis and treatment of pancreatic cancer
10.3760/cma.j.issn.1674-1935.2016.04.001
- VernacularTitle:血清异常凝血酶原水平在胰腺癌诊治中的应用价值
- Author:
Dansheng LEI
;
Jing YU
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Abnormal prothrombin;
Diagnosis;
Monitoring
- From:
Chinese Journal of Pancreatology
2016;16(4):217-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective Serum abnormal prothrombin (PIVKA-Ⅱ) level was detected in pancreatic cancer patients and its clinical value in diagnosing and treating pancreatic cancer was explored.Methods A total of 112 pancreatic cancer patients,28 benign pancreatic diseases patients and 79 healthy controls were collected from Cancer Hospital of Hubei Province.Serum PIVKA-Ⅱ level was determined by chemiluminescent immunoassay (CLIA).CEA and CA19-9 level was detected by electrochemiluminescence immunoassay (ECLIA).Receiver operation characteristic (ROC) curve was drawn and the cut-off value was set.The sensitivity,specificity and accuracy were calculated.Results PIVKA-Ⅱ level in 112 pancreatic cancer patients was 39.0 (22.61,137.67)U/L[median (quartile range)],which was significantly higher than that in 30 patients with benign pancreatic disease [23.0 (17.32,29.67) U/L] and 79 healthy controls [21.21 (17.9,25.12) U/L].The differences were statistically significant (P＜0.01).However,there was no significant difference between benign pancreatic disease patients and healthy controls.ROC analysis showed that area under curve(AUC) for PIVKA-Ⅱ,CEA and CA19-9 was 0.793,0.707 and 0.849.The cut-off value for discriminating pancreatic cancer was established at 32.4,4.7 and 27.0 U/L for PIVKA-Ⅱ,CEA and CA19-9.The sensitivity was 61.6％,38.0％ and 66.1％,and the specificity was 86.3％,96.3％ and 89.9％,and the accuracy was 71.7％,62.3％ and 75.0％,respectively.The sensitivity,specificity and accuracy of PIVKA-Ⅱ combined with CEA and CA19-9 was 90.2％,76.0％ and 84.3％.The sensitivity was obviously higher,while the specificity was lower.Serum PIVKA-Ⅱ level was associated with advanced tumor stage.There were 20 patients who were followed up.PIVKA-Ⅱ level in 15 cases were decreased after surgery or interventional therapy (50.6 U/L vs 110.5 U/L,P ＜0.001),which was increased in 4 of the five cases who received palliative care to a various degree.Conclusions PIVKA-Ⅱ detection could benefit the diagnosis and prognosis monitoring of pancreatic cancer.
