Protein induced by vitamin K absence or antagonist Ⅱ application research in hepatocellular carcinoma
10.3760/cma.j.issn.1000-6680.2017.05.004
- VernacularTitle:维生素K缺乏或拮抗剂Ⅱ诱导的蛋白在肝细胞癌中的应用价值
- Author:
Junli LI
;
Jia SHANG
;
Wei LI
;
Huibin NING
;
Jia HE
;
Ya'nan WU
;
- Keywords:
PIVKA-Ⅱ;
Carcinoma;
hepatocellular;
Diagnosis
- From:
Chinese Journal of Infectious Diseases
2017;35(5):272-277
- CountryChina
- Language:Chinese
-
Abstract:
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, P<0.01).And serum PIVKA-Ⅱ level in cirrhosis group was also higher than that in CHB group (U=481.50,P>0.05).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.
