THE CLINICAL SIGNIFICANCE OF PIVKA-II MEASUREMENT IN PATIENTS WITH PRIMARY HEPATIC TUMOR

Abstract

The clinical significance of PIVKA-II measurement in primary liver cancer was studied. The level of PIVKA-II was normal in all 78 healthy volunteers but it was elevated in 54.7% (35/64 cases) of patients with hepatocellular carcinoma (HCC) and 62.5% (5/8 cases) of patients with cholangiocellular carcinoma (CCC). PIVKA-II was positive in 43.8% (7/16 cases) of α-fetoprotein negative patients with HCC. Combined measurement of PIVKA-II with α-fetoprotein revealed that the positive rate of tumor marker in HCC was increased by about 10% when compared to the sole determination of α-fetoprotein (75.1%). The values from hepaplastin test and thrombotest, and vitamin K dependent factors were not correlated to the plasma levels of PIVKA-II in patients with HCC. These values were increased in PIVKA-II positive patients with HCC when compared to PIVKA-II negative patients. No significant difference in II/V ratio was noted between PIVKA-II positive and negative groups. The levels of vitamin K dependent factors were also relatively high in patients with CCC. Thus, it is suggested that PIVKA-II positive patients whose vitamin K dependent factors and II/V ratio are within normal limit may suffer from the primary hepatic tumor and thereby should be chekced by the radiological examinaitons to demonstrate a possible involvement of hepatic malignancy.