Application of serum protein induced by vitamin K absence or antagonist-II in clinical diagnosis of hepatocellular carcinoma

Objective To investigate the diagnostic value of serum protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in hepatocellular carcinoma (HCC) patients. Methods There were 97 patients enrolled from Peking University First Hospital, including 27 patients with HCC (all with cirrhosis) and 70 patients without HCC (47 patients with cirrhosis and 23 patients without cirrhosis, respectively) . Serum alpha fetoprotein (AFP) and PIVKA-Ⅱ were detected in each group, and their sensitivity and specificity were compared. Meanwhile, receiver operating characteristic (ROC) curve and the correlation analysis of AFP and PIVKA-Ⅱ were carried out. Results Serum AFP and PIVKA-Ⅱ were significantly higher in HCC group than those in non-HCC group (Z=-3.244, -3.329, P both 0.05) . By using different combined dignostic schemes of AFP and PIVKA-Ⅱ, the diagnostic sensitivity and specificity of HCC could achieve 100.00% and 91.43%, respectively. The areas under the ROC curve of AFP, PIVKA-Ⅱ and AFP×PIVKA-Ⅱ were 0.713 (95% CI: 0.594-0.832) , 0.719 (95% CI: 0.607-0.831) and 0.751 (95% CI: 0.636-0.867) , respectively. The Pearson correlated index of AFP and PIVKA-Ⅱ was 0.370 (P<0.01) in all patients, while it was 0.400 (P<0.05) in HCC group. Conclusions The diagnositc value of PIVKA-Ⅱ is similar as AFP, and it can be regarded as a serologic marker for clinical diagnosis of HCC. Moreover, the combined dignostic scheme of AFP and PIVKA-Ⅱ can improve the diagnostic efficiency. Key words: Carcinoma, hepatocellular; Protein induced by vitamin K absence or antagonist-Ⅱ; Alpha fetoprotein