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Diagnostic role and correlation with staging systems of PIVKA-II compared with AFP
Yang-Hyun Baek1, Jong-Hoon Lee, Jin-Seok Jang
1Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Background/Aims:
Alpha-fetoprotein (AFP) and protein-induced by vitamin K absence or antagonist (PIVKA-II) are representative markers of hepatocellular carcinoma (HCC). The aim of this study was to evaluate the usefulness of PIVKA-II when compared with AFP for detecting HCC. Furthermore, we evaluated the correlation between PIVKA-II and HCC staging.
Methodology:
One hundred patients with liver cirrhosis (LC) and 227 with HCC were analyzed between January 2004 and March 2006. To compare the diagnostic value of PIVKA-II and AFP, Receiver operating characteristic curve was constructed.
Results:
The area under the curve indicated a better accuracy for PIVKA-II than AFP in diagnosis of HCC (0.829 vs. 0.712). The positive rates of PIVKA-II in patients with tumor size larger than 5 cm, 3-5 cm, and less than 3 cm were higher than that of AFP (96%, 83%, 74% vs. 65%, 57%, 48%, respectively). In addition, there seems to be correlation between PIVKA-II and staging systems, Tumor Node Metastasis, Cancer of the Liver Italian Program score and Japan Integrated Staging score (p<0.05).
Conclusions:
The results of this study show that a PIVKA-II is a useful marker for detecting HCC, especially in small HCC and may have correlations with known staging systems.
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