PIVKA-II is a useful tumor marker for recurrent hepatocellular carcinoma after surgical resection
PIVKA-II is a useful tumor marker for recurrent hepatocellular carcinoma after surgical resection
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DOI：
10.1159/000111707
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发表时间：
2007-01-01
期刊：
影响因子：
3.5
通讯作者：
Han, Kwang Hyub
中科院分区：
文献类型：
--
作者：
Kim, Do Young;Paik, Yong Han;Han, Kwang Hyub
目的：本研究的目的是评估凝血酶原诱导的维生素K缺乏或拮抗剂-II（PIVKA-II）在监测复发性肝细胞癌（HCC）根治性切除术后的有用性。方法：从2001年4月至2004年3月，共招募了245例经组织学证实的HCC和267例非HCC患者。对27例切除术后复发的HCC患者进行了甲胎蛋白（AFP）和PIVKA-II的系列随访测量。在原发性肝癌诊断中，AFP和PIVKA-II的敏感性分别为48.6%（119/245）和75.1%（184/245），AFP的截止值为20 ng/ml，PIVKA-II的截止值为40 mAU/ml（p < 0.01）。特异性分别为81.3%（217/267）和94.8%（253/267）。联合检测AFP和PIVKA-II的敏感性和特异性分别为83.3%（204/245）和77.2%（206/267）。在27例肝癌根治性切除术后复发的患者中，AFP和PIVKA-II的敏感性分别为40.7%（11/27）和74.1%（20/27）。从初次诊断到复发，观察到AFP和PIVKA-II的多种波动模式。结论：我们的数据表明PIVKA-II是HCC的一种有用的肿瘤标志物，与AFP互补。切除术后连续检测这两种标志物可能有助于肿瘤复发的早期诊断。
Objectives: The aim of this study is to assess the usefulness of prothrombin induced by vitamin K absence or antagonist-II ( PIVKA-II) in monitoring of recurrent hepatocellular carcinoma (HCC) after curative resection.Methods: From April 2001 to March 2004, a total of 245 patients with histologically proven HCC and 267 non-HCC patients were recruited. Serial follow-up measurements of both alpha-fetoprotein (AFP) and PIVKA-II were performed in 27 patients who had recurrent HCC after resection.Results: In the initial HCC diagnosis, the sensitivity of AFP and PIVKA-II was 48.6% (119/245) and 75.1% (184/245), respectively, at the cutoff of 20 ng/ml for AFP and 40 mAU/ml for PIVKA-II (p < 0.01). The specificity was 81.3% (217/267) and 94.8% (253/267), respectively. When AFP and PIVKA-II were combined, the sensitivity and specificity was 83.3% (204/245) and 77.2% (206/267), respectively. In 27 patients developing recurrent HCC after curative surgical resection, the sensitivity of AFP and PIVKA-II was 40.7% (11/27) and 74.1% (20/27), respectively. Several fluctuating patterns of AFP and PIVKA-II were observed from initial diagnosis to recurrence.Conclusion: Our data suggest that PIVKA-II is a useful tumor marker for HCC, complementary to AFP. Serial measurements of both markers after resection might be helpful for early diagnosis of tumor recurrence.