Clinical application of serum PIVKA-Ⅱ in diagnosis of primary liver cancer

Abstract

Abstract: Objective To investigate the clinical value of serum prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ) in diagnosis of primary liver cancer.Methods Peripheral venous blood serum was collected from 330 patients from February 2016 to November 2016 in our hospital. Serum PIVKA-Ⅱ and alpha-fetoproteins (AFP) levels were measured using LUMI-PULSE G1200 automated immunoassay analyzer, and further analyzed for evaluating their clinical value in diagnosing and monitoring primary liver cancer.Results Serum levels of both PIVKA-Ⅱ and AFP in primary liver cancer group were higher than those in chronic hepatitis group and liver cirrhosis group (PIVKA-Ⅱ:U=1016, 280.5, 582.5, P=0.00, 0.00, 0.00; AFP:U=3534, 1225, 2849,P=0.00, 0.00, 0.00). The sensitivity of serum PIVKA-Ⅱ (83.19%) and combination of PIVKA-Ⅱ and AFP (89.38%) was higher than serum AFP (66.37%, adjusted χ²=7.60, P=0.006, χ²=16.05, P=0.00) in diagnosing primary liver cancer, respectively. The serum level of PIVKA-Ⅱ was positively correlated with tumor volume (r=0.63, P=0.00), and the sensitivity of detection was positively correlated with tumor size. The serum level of PIVKA-Ⅱ was higher in stage Ⅲ and IV than that in stage I and Ⅱ, respectively (Ⅲ: U=151.00, 173.00, P= 0.00, 0.04; IV: U=238.50, 292.50, P=0.00, 0.02). The serum levels of PIVKA-Ⅱ and AFP had no significant correlation with tumor differentiation. The serum levels of PIVKA-Ⅱ and AFP were significantly increased in early primary liver cancer with portal vein thrombosis, intrahepatic metastasis and lymph node enlargement (U=134.00,183.00, P=0.00, 0.01). The levels of serum PIVKA-Ⅱ and AFP were significantly decreased in patients with primary liver cancer after operation or intervention therapy (Z= -5.08,-4.28, P=0.00, 0.00), and the level of serum PIVKA-Ⅱ (80.13%) decreased more than the level of AFP (57.87%, χ²=4.226, P=0.04).Conclusion PIVKA-Ⅱ detection had a higher sensitivity and specificity for diagnosing primary liver cancer than AFP, which could be used as a tumor marker for clinical detection and prediction of primary liver cancer prognosis.

Key words: Primary liver cancer, PIVKA-Ⅱ, AFP

QIN Ya-nan, HONG Lei, SONG Zheng-xia, DING Qin. Clinical application of serum PIVKA-Ⅱ in diagnosis of primary liver cancer[J]. Chinese Hepatolgy, 2017, 22(12): 1103-1106.

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