Optimal Cut-off Value of PIVKA-II for Diagnosis of Hepatocellular Carcinoma: Using ROC Curve.
- Author:
Myong Jin KIM
1
;
Kang Woo BAE
;
Pyoung Ju SEO
;
In Kook JEONG
;
Jung Hyuk KIM
;
Bo Han LEE
;
Ki Tae BANG
;
Dong Woo KIM
;
Il Han SONG
Author Information
1. Department of Internal Medicine, Dankook University College of Medicine, Choenan, Korea. ihsong21@dankook.ac.kr
- Publication Type:Original Article ; English Abstract ; Randomized Controlled Trial
- Keywords:
Hepatocellular carcinoma;
PIVKA-II;
alpha-Fetoproteins;
ROC curve;
Diagnosis
- MeSH:
Adult;
Aged;
Biological Markers/*blood;
Carcinoma, Hepatocellular/*diagnosis;
Female;
Humans;
Liver Neoplasms/*diagnosis;
Male;
Middle Aged;
Predictive Value of Tests;
Protein Precursors/*blood;
Prothrombin;
ROC Curve;
Tumor Markers, Biological/*blood;
alpha-Fetoproteins/analysis
- From:The Korean Journal of Hepatology
2006;12(3):404-411
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Protein induced by vitamin K absence or antagonist-II (PIVKA-II), also known as des-carboxyprothrombin (DCP), can be used as an alternative tool to alpha-fetoprotein (AFP) for surveillance of hepatocellular carcinoma (HCC). The aims of the present study were to compare PIVKA-II levels between the patients with HCC and patients with non-HCC chronic liver disease, to evaluate the correlation of PIVKA-II and AFP in HCC patients, and finally to estimate the optimal cut-off value for PIVKA-II for the diagnosis of HCC with using the receiver operating characteristic (ROC) curve. METHODS: A total of 227 consecutive patients with HCC (n=42) or chronic liver disease (n=185) were enrolled in this study. HCC was diagnosed histologically or by imaging such as computed tomography, magnetic resonance imaging or angiography. The serum PIVKA-II and AFP levels were measured by electrochemiluminoimmunoassay with using the Haicatch PIVKA-II kit and by immunoradiometric assay, respectively. RESULTS: The PIVKA-II level in the HCC patients was significantly higher than the non-HCC chronic liver disease patients (903.0+/-1156.7 vs. 111.7+/-211.0 mAU/ mL, respectively, P<0.01). PIVKA-II and AFP showed a statistical correlation in HCC patients (r=0.46, P<0.01). The sensitivity and specificity of PIVKA-II for the diagnosis of HCC were 66.7% and 74.1%, respectively, and when tasted together with AFP, the sensitivity was increased by 85.7%. For the ROC curve of PIVKA-II in HCC patients, the specificity of a 250 mAU/mL level of PIVKA-II was 95%. CONCLUSIONS: PIVKA-II was as useful surveillance tool for differentiating HCC from chronic liver disease, and a PIVKA-II value of 250 mAU/ mL was proposed as a significant cut-off value for diagnosis of hepatocellular carcinoma.
