Clinical Usefulness of Plasma Abnormal Prothrombin (PIVKA-2) in Patients with Hepatocellular Carcinoma

Choi, Soh Young; Lee, Ok Jae; Kim, Jeong Yeol; Kim, Young Chai

Abstract

BACKGROUND AND AIMS: The clinical usefulness of plasrna abnormal prothrombin (prothrombin induced by vitamin K absence or antagonist II, PIVKA-II), as a tumor marker for hepatocellular carcinoma (HCC) has been reported, and its diagnostic significance as a tumor marker for HCC was evaluated.
METHODS
Plasma PIVKA-II concentrations were determined by a latex agglutination technique using anti-prothrombin antibodles, and serum levels of a-fetoprotein (AFP) were determined in 26 patients with HCC, 42 patients with chronic liver diseases including 37 patients with liver cirrhosis, and 11 normal healthy controls.
RESULTS
Sixteen (61.5%) out of 26 patients with HCC had an abnormal PIVKA-II level above 1.0 pg/ml. There was no statistically significant difference between the HCC and control groups (p=0.05). Twenty (76.9%) out of 26 patients with HCC had an abnormal AFP level above 20 ng/ml. Yhere was statistically significant difference between the HCC and control groups (p<0.01). The sensitivity and specificity of PIVKA-II in the diagnosis of HCC were 61.5%, 51.4% at the cut off value of lpg/tnl and those of AFP were 76.9%, 78.4% at the cut off value of 20 ng/ml, respectively. By the combined assay with the cut off values of AFP above 100 ng/ml and PIVKA-II above 1 pg/ml, the diagnostic accuracy for HCC could be improved to 88.5%. The relation.;hip between PIVKA-II and AFP levels in patients with HCC was not observed.
CONCLUSIONS
The sensitivity and specificity of PIVKA-Il in the diagnosis of HCC are not higher than AFP, Howeves, PIVKA-II can improve the accuracy for diagnosis of HCC by combined assay with AFP.