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Updated: Jul 9, 2026
The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
PIVKA-II is a useful tumor marker for recurrent hepatocellular carcinoma after surgical resection
Do Young Kim1, Yong Han Paik, Sang Hoon Ahn
1Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Yonsei Liver Cancer Special Clinic, Severance Hospital, Liver Cirrhosis Clinical Research Center, Seoul, Korea.
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.
