Diagnostic value of PIVKA-Ⅱ and alpha-fetoprotein in hepatitis B virus-associated hepatocellular carcinoma

被引：55

作者：

Seung In Seo ^{[1
,2
]}

Hyoung Su Kim ^{[1
,2
]}

Won Jin Kim ^{[1
,2
]}

Woon Geon Shin ^{[1
,2
]}

Doo Jin Kim ^{[2
,3
]}

Kyung Ho Kim ^{[1
,2
]}

Myoung Kuk Jang ^{[1
,2
]}

Jin Heon Lee ^{[1
,2
]}

Joo Seop Kim ^{[2
,3
]}

Hak Yang Kim ^{[1
,2
]}

Dong Joon Kim ^{[1
]}

Myung Seok Lee ^{[1
]}

Choong Kee Park ^{[1
]}

机构：

[1] Department of Internal Medicine,Hallym University Medical Center,Seoul 134-701,South Korea

[2] Digestive Disease Center,Hallym University Medical Center,Seoul 134-701,South Korea

[3] Department of Surgery,Hallym University Medical Center,Seoul 134-701,South Korea

来源：

World Journal of Gastroenterology | 2015年 / 21卷 / 13期

关键词：

Hepatitis B virus; Hepatocellular carcinoma; Alpha-fetoprotein; Prothrombin induced by vitamin K absence-Ⅱ;

D O I：

暂无

中图分类号：

R735.7 [肝肿瘤];

学科分类号：

100214 ;

摘要：

AIM: To determine the cutoff values and to compare the diagnostic role of alpha-fetoprotein(AFP) and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ) in chronic hepatitis B(CHB).METHODS: A total of 1255 patients with CHB, including 157 patients with hepatocellular carcinoma(HCC), 879 with non-cirrhotic CHB and 219 with cirrhosis without HCC, were retrospectively enrolled. The areas under the receiver operating characteristic(AUROC) curves of PIVKA-Ⅱ, AFP and their combination were calculated and compared.RESULTS: The optimal cutoff values for PIVKA-Ⅱ and AFP were 40 m AU/m L and 10 ng/m L, respectively, for the differentiation of HCC from nonmalignant CHB. The sensitivity and specificity were 73.9% and 89.7%, respectively, for PIVKA-Ⅱ and 67.5% and 90.3% for AFP, respectively. The AUROC curves of both PIVKA-Ⅱ and AFP were not significantly different(0.854 vs 0.853, P = 0.965) for the differentiation of HCC from nonmalignant CHB, whereas the AUROC of PIVKA-Ⅱ was significantly better than that of AFP in patients with cirrhosis(0.870 vs 0.812, P = 0.042). When PIVKA-Ⅱ and AFP were combined, the diagnostic power improved significantly compared to either AFP or PIVKA-Ⅱ alone for the differentiation of HCC from nonmalignant CHB(P < 0.05), especially when cirrhosis was present(P < 0.05).CONCLUSION: Serum PIVKA-Ⅱ might be a better tumor marker than AFP, and its combination with AFP may enhance the early detection of HCC in patients with CHB.

引用

页码：3928 / 3935

页数：8

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