Better performance of PIVKA-II for detecting hepatocellular carcinoma in patients with chronic liver disease with normal total bilirubin  

作　　者：Xiang-Jun Qian Zhu-Mei Wen Xiao-Ming Huang Hui-Juan Feng Shan-Shan Lin Yan-Na Liu Sheng-Cong Li Yu Zhang Wen-Guang Peng Jia-Rui Yang Zhe-Yu Zheng Lei Zhang Da-Wei Zhang Feng-Min Lu Li-Juan Liu Wei-Dong Pan 

机构地区：[1]Department of Pancreatic Hepatobiliary Surgery,The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,Guangdong Province,China [2]Department of Microbiology&Infectious Disease Center,School of Basic Medical Sciences,Peking University Health Science Center,Beijing 100191,China [3]Department of Laboratory Medicine,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou 350025,Fujian Province,China [4]Johns Hopkins Bloomberg School of Public Health,Johns Hopkins University,Baltimore,MD 21205,United States

出　　处：《World Journal of Gastroenterology》2023年第8期1359-1373,共15页世界胃肠病学杂志（英文版）

基　　金：Supported by the National Key Clinical Discipline,Fuzhou “14th Five-Year Plan” Clinical Key Specialty (laboratory medicine);the National Science Foundation of China,No. 82002587

摘　　要：BACKGROUND Serum protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ) is a promising biomarker for hepatocellular carcinoma(HCC) surveillance.AIM To identify the contributing factors related to the abnormal elevation of PIVKA-Ⅱ level and assess their potential influence on the performance of PIVKA-Ⅱ in detecting HCC.METHODS This study retrospectively enrolled in 784 chronic liver disease(CLD) patients and 267 HCC patients in Mengchao Hepatobiliary Hospital of Fujian Medical University from April 2016 to December 2019. Logistic regression and the area under the receiver operating characteristic curve(AUC) were used to evaluate the influencing factors and diagnostic performance of PIVKA-Ⅱ for HCC, respectively.RESULTS Elevated PIVKA-Ⅱ levels were independently positively associated with alcohol-related liver disease, serum alkaline phosphatase(ALP), and total bilirubin(TBIL) for CLD patients and aspartate aminotransferase(AST) and tumor size for HCC patients(all P < 0.05). Serum PIVKA-Ⅱ were significantly lower in patients with viral etiology, ALP ≤ 1 × upper limit of normal(ULN), TBIL ≤ 1 × ULN, and AST ≤ 1 × ULN than in those with nonviral disease and abnormal ALP, TBIL, or AST(all P < 0.05), but the differences disappeared in patients with early-stage HCC. For patients with TBIL ≤ 1 × ULN, the AUC of PIVKA-Ⅱ was significantly higher compared to that in patients with TBIL > 1 × ULN(0.817 vs 0.669, P = 0.015), while the difference between ALP ≤ 1 × ULN and ALP > 1 × ULN was not statistically significant(0.783 vs 0.729, P = 0.398). These trends were then more prominently perceived in subgroups of patients with viral etiology and HBV alone.CONCLUSION Serum PIVKA-Ⅱ has better performance in detecting HCC at an early stage for CLD patients with normal serum TBIL.

关 键 词：Protein induced by vitamin K absence or antagonist-II Chronic liver disease Total bilirubin Hepatocellular carcinoma Diagnosis Hepatitis B virus 

分 类 号：R575[医药卫生—消化系统] R735.7[医药卫生—内科学]