Impact of PIVKA-II in diagnosis of hepatocellular carcinoma

Abstract

Liver cancer grows silently with mild or no symptoms until advanced. In the absence of an effective treatment for advanced stage of hepatic cancer hope lies in early detection, and screening for high-risk population. Among Egyptians viral hepatitis is the most common risk factor for hepatocellular carcinoma (HCC). The current work was designed to determine the level of prothrombin induced by vitamin K absence-II (PIVKA-II) in sera of patients suffering from HCC and hepatitis C virus (HCV) patients being the most common predisposing factor for HCC. Our ultimate goal is diagnosis of HCC at its early stage. The current study was carried out on 83 individuals within three groups; Normal control, HCV and HCC groups. Patients were subdivided into cirrhotic and non-cirrhotic. Complete clinicopathological examination was carried out for each individual to confirm diagnosis. Individuals’ sera were subjected to quantitative determination of alpha-fetoprotein (AFP), PIVKA-II and other parameters. PIVKA-II proved to be superior to AFP for early detection of HCC patients being highly sensitive and specific. Furthermore it has the ability to discriminate between different histopathological grades of HCC and It has a powerful diagnostic validity to evaluate the thrombosis of portal vein and to differentiate between early and late stages of HCC. The direct relation between the level of PIVKA-II and the size of tumor makes it an attractive tool for early HCC diagnosis and surveillance. Using the best cut-off value of AFP (>28), showed a sensitivity of (44%) and specificity of (73.3%). While cut-off value of PIVKA-II (>53.7) showed 100% sensitivity and specificity.

The Influence of C936T Gene in Wild of the Vascular Endothelial Growth Factor and Biochemical Variants Analysis for Alpha-Fetoprotein in Hepatocellular Carcinoma Patients in Egypt

“…In the present study there was a highly significant increase in serum creatinine activity in the HCC group compared to control and untreated HCV infected group P<0.001, P = 0.004 respectively, this result disagree with Nguyen et al [37] and Zakhary et al [38] who reported that the level of creatinine non significantly decrease in HCC group compared to other studied groups.…”

“…In our study when using receiving operator characterizing curve (ROC curve) to reach the value of the best sensitivity and specificity for AFP, it was found that at a value of 3.39 ng/ml (the best cut off) yields, the sensitivity was 52% and the specificity was 40%. Zakhary et al [38] reported a cutoff of as a diagnostic cutoff. According to our results, at a cut-off 28 ng/dl shows the sensitivity was (73.3%) and specificity was (75%).…”

Can Glypican3 be Diagnostic for Early Hepatocellular Carcinoma among Egyptian Patients?

“…So, they concluded that GPC-3 is a sensitive serum and tissue marker for the diagnosis of early HCC. Several studies have shown that Glypican-3 is superior to AFP in early detection of HCC, being highly sensitive and specific (Suriawinata et al, 2010;Zakhary et al, 2012). Studies performing double combination of Glypican-3 and AFP found sensitivities between (84%-92%) and specificities between (90%-95%).…”

Diagnostic Accuracy of PIVKA-II, Alpha-Fetoprotein and a Combination of both in Diagnosis of Hepatocellular Carcinoma in Patients Affected by Chronic HCV Infection

“…For these reasons, some authors, and especially Japanese guidelines on HCC management proposed the use of PIVKA-II for routine follow-up in patients with high risk for developing HCC (5,20), as well as a prognostic biomarker before surgery to predict microvascular invasion, relapse and overall poor prognosis (14)(15)(16)(17). In detail, Japanese guidelines have suggested to consider as a diagnostic marker of HCC high elevation of tumor markers, namely AFP ≥200 ng/ml and PIVKA-II ≥40 mAU/ml.…”