Real impact of tumor marker AFP and PIVKA-II in detecting very small hepatocellular carcinoma(≤2 cm,Barcelona stage 0)-assessment with large number of cases  

作　　者：Kazuo Tarao Akito Nozaki Hirokazu Komatsu Tatsuji Komatsu Masataka Taguri Katsuaki Tanaka Makoto Chuma Kazushi Numata Shin Maeda 

机构地区：[1]Department of Gastroenterology,Tarao’s Gastroenterological Clinic,Yokohama 241-0821,Japan [2]Gastroenterological Center,Yokohama City University Medical Center,Yokohama 232-0024,Japan [3]Department of Gastroenterology,Yokohama Municipal Citizen’s Hospital,Yokohama 221-0855,Japan [4]Department of Clinical Research,National Hospital Organization Yokohama Medical Center,Yokohama 245-8575,Japan [5]Department of Data Science,Yokohama City University School of Data Science,Yokohama 236-0004,Japan [6]Department of Gastroenterology,Hadano Red Cross Hospital,Kanagawa 221-0045,Japan [7]Department of Gastroenterology,Yokohama City University Graduate School of Medicine,Yokohama 236-0004,Japan

出　　处：《World Journal of Hepatology》2020年第11期1046-1054,共9页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are relevant as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.AIM To examine the impact of the tumor marker alpha-fetoprotein(AFP)or PIVKA-II in detecting very small HCC nodules(≤2 cm in maximum diameter,Barcelona stage 0)in the large number of very small HCC.The difference in the behavior of these tumor markers in HCC development was also examined.METHODS A total of 933 patients with single-nodule HCC were examined.They were subdivided into 394 patients with HCC nodules≤2 cm in maximum diameter and 539 patients whose nodules were>2 cm.The rates of patients whose AFP and PIVKA-II showed normal values were examined.RESULTS The positive ratio of the marker PIVKA-II was significantly different(P<0.0001)between patients with nodules≤2 cm in diameter and those with nodules>2 cm,but there was no significant difference in AFP(P=0.4254).In the patients whose tumor was≤2 cm,50.5%showed normal levels in AFP and 68.8%showed normal levels in PIVKA-II.In 36.4%of those patients,both AFP and PIVKA-II showed normal levels.The PIVKA-II-positive ratio was markedly increased with an increase in the tumor size.In contrast,the positivity in AFP was increased gradually and slowly.CONCLUSION In the surveillance of very small HCC nodules(≤2 cm in diameter,Barcelona clinical stage 0)the tumor markers AFP and PIVKA-II are not so useful.

关 键 词：Hepatocellular carcinoma AFP PIVKA-II Barcelona clinical stage Tumor markers 

分 类 号：R735.7[医药卫生—肿瘤]