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

被引：72

作者：

Seo, Seung In ^{[1
,2
]}

Kim, Hyoung Su ^{[1
,2
]}

Kim, Won Jin ^{[1
,2
]}

Shin, Woon Geon ^{[1
,2
]}

Kim, Doo Jin ^{[2
]}

Kim, Kyung Ho ^{[1
,2
]}

Jang, Myoung Kuk ^{[1
,2
]}

Lee, Jin Heon ^{[1
,2
]}

Kim, Joo Seop ^{[2
,3
]}

Kim, Hak Yang ^{[1
,2
]}

Kim, Dong Joon ^{[1
,3
]}

Lee, Myung Seok ^{[1
]}

Park, Choong Kee ^{[1
]}

机构：

[1] Hallym Univ, Med Ctr, Dept Internal Med, Seoul 134701, South Korea

[2] Hallym Univ, Med Ctr, Ctr Digest Dis, Seoul 134701, South Korea

[3] Hallym Univ, Med Ctr, Dept Surg, Seoul 134701, 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; GAMMA-CARBOXY PROTHROMBIN; ENZYME-IMMUNOASSAY KIT; PRIMARY LIVER-CANCER; VITAMIN-K ABSENCE; ABNORMAL PROTHROMBIN; SERUM-LEVELS; CIRRHOSIS; CARBOXYPROTHROMBIN; SENSITIVITY; POPULATION;

D O I：

10.3748/wjg.v21.i13.3928

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

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 mAU/mL and 10 ng/mL, 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

共 40 条

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