Elevated PIVKA-II is Associated with Early Recurrence and Poor Prognosis in BCLC 0-A Hepatocellular Carcinomas

Wang, Beili; Tan, Qiwen; Gao, Xinjie; Wu, Jiong; Guo, Wei

doi:10.7314/apjcp.2014.15.16.6673

Cited by 25 publications

(26 citation statements)

References 25 publications

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“…To our knowledge, only one study has reported the role the cutoff value of PIVKA-II determined using ROC curve analysis in predicting ER after hepatectomy. 20 In this study, we found that an area under the ROC curve of 0.804 (cutoff value = 46 mAU/mL) for PIVKA-II showed a good predictive performance regarding ER after hepatectomy. However, it remains to be confirmed whether the predictive value of the PIVKA-II level can be generalized to patients undergoing hepatectomy.…”

Section: Discussionmentioning

confidence: 55%

“…18,19 In addition, there is now a large body of evidence indicating that PIVKA-II has a p prognostic and predictive value for recurrence after hepatic resection. [20][21][22][23] Most studies use a predefined value of PIVKA-II based on existing knowledge to evaluate risk factors for ER after hepatectomy. To our knowledge, only one study has reported the role the cutoff value of PIVKA-II determined using ROC curve analysis in predicting ER after hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

et al. 2017

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Early recurrence is common after curative hepatectomy for hepatocellular carcinoma and is associated with poor prognosis. This study aimed to identify risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma. Overall, 63 patients who underwent curative hepatectomy for hepatocellular carcinoma were enrolled. Patients were divided into the early recurrence group, who developed recurrence within 12 months after hepatectomy (n = 10), and the non-early recurrence group (n = 53). Clinicopathological factors of early recurrence were retrospectively analyzed. Among the 63 patients, 10 (15.9%) patients experienced early recurrence. Univariate analysis showed tumor necrosis (p = 0.012), level of PIVKA-II (prothrombin induced by vitamin K absence or antagonist-II; p = 0.002), and microvascular invasion (p = 0.029) to be associated with early recurrence. By multivariate analysis, there were significant differences in high PIVKA-II (p < 0.001) and tumor necrosis (p = 0.012) in patients with early recurrence. The optimal cutoff values of PIVKA-II and tumor necrosis were 46 mAU/mL and 3% of total tumor volume, respectively. Patients with a high preoperative PIVKA-II level and extent of tumor necrosis, which are independent risk factors for early recurrence, should be actively treated and monitored closely after hepatectomy.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

et al. 2017

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“…The conclusions about the relation between AFP, PIVKA-II and clinicopathologic features (such as vascular invasion, tumor differentiation and size) were different, even controversial [9][10][11][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…There were few studies on the correlation between the above two indicators and vascular invasion, tumor differentiation and size. And the conclusions are controversial [9][10][11]. The aim of the study was to evaluate the diagnostic value of PIVKA-II and AFP in the diagnosis of HCC and futher analysis the level of AFP and PIVKA-II in HCC patients with different clinicopathologic characteristics such as tumor differentiation and vascular invasion.…”

Section: Introductionmentioning

confidence: 99%

Value of AFP and PIVKA-II in diagnosis of primary hepatocellular carcinoma and prediction of vascular invasion and tumor differentiation

Wang

Fan

et al. 2019

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Background: To explore the value of alpha fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in diagnosis of primary hepatocellular carcinoma (HCC) and their relationship with vascular invasion, tumor differentiation and size. Methods: A total of 433 participants were enrolled in this study including 266 cases with HCC, 87 cases with liver cirrhosis and 80 healthy individuals. Then we explored the correlation between AFP, PIVKA-II serum level and several pathological features such as vascular invasion, tumor differentiation and size. The value of these two markers used singly or jointly in diagnosing HCC was evaluated by receiver operating characteristic (ROC) curve. The ROC curve was also plotted to identify AFP, PIVKA-II serum cut-off values that would best distinguish HCC patients with and without vascular invasion. Results: The level of AFP and PIVKA-II in HCC group was significantly higher (Z was 7.428, 11.243 respectively, all P<0.01). When AFP and PIVKA-II were used as the individual tumor marker, the areas under the ROC curve (AUC) of HCC diagnosis were 0.765 (95% CI, 0.713～0.8170) for AFP, 0.901 (95% CI, 0.868～0.935) for PIVKA-II, and 0.917 (95% CI, 0.886～0.948) for AFP and PIVKA-II simultaneously. The serum levels of AFP and PIVKA-II were positively correlated with tumor differentiation and size. High AFP and PIVKA-II expression was signiﬁcantly associated with the presence of vascular invasion (P was 0.007 and 0.014 respectively). The AFP level >64.4ng/ml or PIVKA-II level >957.61mAU/ml was the best critical value to predict the presence of vascular invasion. Conclusion: The diagnostic value of AFP and PIVKA-II combined detection or single assay of PIVKA-II is higher than that of separate assay of AFP. And the proper concentration has important clinical value for judging tumor size, tumor cell differentiation and vascular invasion. Above results validate that AFP and PIVKA-II play a significant role in the diagnosis of HCC.

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Section: Introductionmentioning

confidence: 99%

Value of AFP and PIVKA-II in Diagnosis of Primary Hepatocellular Carcinoma and Prediction of Vascular Invasion and Tumor Differentiation

Wang

Fan

et al. 2020

Preprint

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Background: To explore the value of alpha fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in diagnosis of primary hepatocellular carcinoma (HCC) and their relationship with vascular invasion, tumor differentiation and size. Methods: A total of 433 participants were enrolled in this study including 266 cases with HCC, 87 cases with liver cirrhosis and 80 healthy individuals. Then we explored the correlation between AFP, PIVKA-II serum level and several pathological features such as vascular invasion, tumor differentiation and size. The value of these two markers used singly or jointly in diagnosing HCC was evaluated by receiver operating characteristic (ROC) curve. The ROC curve was also plotted to identify AFP, PIVKA-II serum cut-off values that would best distinguish HCC patients with and without vascular invasion.Results: The level of AFP and PIVKA-II in HCC group was significantly higher (Z was 7.428, 11.243 respectively, all P<0.01). When AFP and PIVKA-II were used as the individual tumor marker, the areas under the ROC curve (AUC) of HCC diagnosis were 0.765 (95% CI, 0.713～0.8170) for AFP, 0.901 (95% CI, 0.868～0.935) for PIVKA-II, and 0.917 (95% CI, 0.886～0.948) for AFP and PIVKA-II simultaneously. The serum levels of AFP and PIVKA-II were positively correlated with tumor differentiation and size. High AFP and PIVKA-II expression was signiﬁcantly associated with the presence of vascular invasion (P was 0.007 and 0.014 respectively). The AFP level >64.4ng/ml or PIVKA-II level >957.61mAU/ml was the best critical value to predict the presence of vascular invasion. Conclusion: Our results validate that AFP and PIVKA-II play a significant role in the diagnosis of HCC. The diagnostic value of AFP and PIVKA-II combined detection or single assay of PIVKA-II is higher than that of separate assay of AFP. Moreover, their concentration has important clinical value in judging tumor size, tumor cell differentiation and vascular invasion.

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Elevated PIVKA-II is Associated with Early Recurrence and Poor Prognosis in BCLC 0-A Hepatocellular Carcinomas

Cited by 25 publications

References 25 publications

Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

Value of AFP and PIVKA-II in diagnosis of primary hepatocellular carcinoma and prediction of vascular invasion and tumor differentiation

Value of AFP and PIVKA-II in Diagnosis of Primary Hepatocellular Carcinoma and Prediction of Vascular Invasion and Tumor Differentiation

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