Efficacy of PIVKA-II in prediction and early detection of hepatocellular carcinoma: a nested case-control study in Chinese patients.

Rentao Yu,Yi Zhou,Zhaoxia Tan,Xiaomei Xiang,Haoliang Wang,Guohong Deng

doi:10.1038/srep35050

Abstract

Prognosis of hepatocellular carcinoma (HCC) remains unsatisfying due to a lack of early detecting methods. Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) has been proved to be an efficient biomarker for HCC. However, the predicting efficacy of PIVKA-II has barely been reported. In the Hepatitis Biobank of Southwest Hospital (HBS) cohort at Southwest Hospital, we did a two-stage nested case-control study. Totally, 45 HCC cases versus 138 matched controls were enrolled to compare levels of α-fetoprotein (AFP) and PIVKA-II in sequential sera at −12, −9, −6, −3 and 0 months before imaging diagnosis. Levels of both PIVKA-II and AFP in HCC cases elevated significantly at all time points compared with controls. In validation stage, the sensitivity and specificity of PIVKA-II at baseline were 58.3% and 92.6%, and AFP were 75.0% and 91.7%. AFP-/PIVKA-II+ patients covered 27.4%, 29.4% and 19.6% at M-12, M-6 and M-0, respectively, while AFP+/PIVKA-II- patients covered 25.5%, 19.6% and 17.7%, respectively. Both PIVKA-II and AFP have the potential for HCC prediction, while PIVKA-II has a better positive rate than AFP before diagnosis.

Highlights

Prognosis of hepatocellular carcinoma (HCC) remains unsatisfying due to a lack of early detecting methods
hepatitis B virus (HBV) DNA were controlled under detecting level in most patients and controls (67.6% vs 73.3%), but cirrhotic basis was 66.7%, and 73.3% were diagnosed at Barcelona Clinic Liver Cancer (BCLC) 0 or A stage
AST, ALT, ALP, TBIL and TBA showed no differences between patients and controls, but TP level elevated significantly in HCC patients compared with chronic hepatitis B (CHB) controls (P = 0.024)

Summary

Introduction

Prognosis of hepatocellular carcinoma (HCC) remains unsatisfying due to a lack of early detecting methods. Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) has been proved to be an efficient biomarker for HCC. 45 HCC cases versus 138 matched controls were enrolled to compare levels of α-fetoprotein (AFP) and PIVKA-II in sequential sera at −12, −9, −6, −3 and 0 months before imaging diagnosis. Levels of both PIVKA-II and AFP in HCC cases elevated significantly at all time points compared with controls. Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II), known as Des-γ-carboxy-prothrombin (DCP), is another marker specific for HCC from 198410. An early study from HALT-C trail showed that www.nature.com/scientificreports/

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Conclusion