Diagnostic accuracy of PIVKA-II, ALPHA-Fetoprotein and a combination of both in diagnosis of Hepatocellular Carcinoma

Patients affected by liver cirrhosis are at high risk for developing hepatocellular carcinoma. The aim of this study was to evaluate the feasibility of PIVKA-II (protein induced by vitamin K absence or antagonist-II) alone or in combination with α-1 fetoprotein, as a screening marker for development of hepatocellular carcinoma. Subjects and methods: A case-control study was conducted on 103 Military Hospital. 53 patients affected by hepatocellular carcinoma were considered as cases, while 31 patients affected by liver cirrhosis were considered as control. Results: At the set cut-off value of 40 mAU/mL, PIVKA-II was more sensitive (92.45% vs. 81.13%), but less specific than α-1 fetoprotein at the set cut-off value of 10 ng/mL (61.29% vs. 83.87%). The negative predictive value of PIVKA in combination with α-1 fetoprotein was 88.23% and the sensitive was 96.2%. Conclusion: PIVKA- II was more sensitive but less specific than α-1 fetoprotein in diagnosis of hepatocellular carcinoma and PIVKA-II, when combined with α-1 fetoprotein, may be considered as a screening test for hepatocellular carcinoma due to its high sensitive and negative predictive value.
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Diagnostic accuracy of PIVKA-II, ALPHA-Fetoprotein and a combination of both in diagnosis of Hepatocellular Carcinoma