Role of PIVKA-II in screening for malignancies at a hepatobiliary andpancreatic disease center: A large-scale real-world study  

作　　者：Chenghao Ge Mingjie Luo Kaiyuan Guo Dong Zhu Ning Han Tengjiao Wang Xiuying Zhao 

机构地区：[1]Department of Clinical Laboratory,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China [2]Tsinghua Clinical Research Institute,Tsinghua University,Beijing 100084,China [3]School of Medicine,Tsinghua University,Beijing 100084,China [4]State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou,Guangdong 510060,China

出　　处：《iLIVER》2022年第4期209-216,共8页国际肝胆健康（英文）

基　　金：This study was supported by Beijing Tsinghua Changgung Hospital Fund(Grant No.12022C1009).

摘　　要：Background and aims:Protein induced by vitamin K absence or antagonist II(PIVKA-II)is a well-accepted biomarker for diagnosing hepatocellular carcinoma(HCC).Although nonspecific increase of PIVKA-II has been reported,real-world evidence remains scarce.Based on real-world data,this study aimed to comprehensively describe the use of PIVKA-II at a hepatobiliary and pancreatic disease center and to assess its utility for the initial screening of HCC or other hepatobiliary–pancreatic malignancies.Methods:This real-world retrospective study is based on the PIVKA-II results of 16,215 individuals and other relevant laboratory test(alpha-fetoprotein[AFP],carbohydrate antigen 19-9[CA19-9],liver function,blood coagulation indicators,hepatitis B virus,and hepatitis C virus).However,only the first PIVKA-II results of 7809 eligible individuals were included.Between-group comparisons,correlation analysis,and receiver operating characteristic curve analysis were performed.Results:PIVKA-II results were abnormal in patients with HCC(55.9%),biliary carcinoma(BC,13.4%),gastroin-testinal and pancreatic cancer(6.3%),and benign diseases(23.5%)as well as in healthy individuals(0.92%).The area under the curve of PIVKA-II for detecting malignancies was 0.7754(0.7620–0.7688),whereas that for detecting HCC was 0.7509(0.7357–0.7662).Stratifying the PIVKA-II values or combining PIVKA-II with AFP or CA19-9 helped improve the diagnostic performance of PIVKA-II for HCC.PIVKA-II values were significantly positively correlated with AST in patients with HCC and with bilirubin in patients with BC.Conclusions:This study determined the role of PIVKA-II in malignancy screening at hepatobiliary and pancreatic disease centers.It was also noted that the diagnostic efficacy of PIVKA-II for HCC improved after combining PIVKA-II with AFP or stratifying its value.

关 键 词：Protein induced by vitamin K absence Or antagonist II Hepatocellular carcinoma Hepatobiliary and pancreatic diseases Real-world study 

分 类 号：R73[医药卫生—肿瘤]