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肝细胞癌:PIVKA-II可能不适合印度患者

Dinesh Jothimani¹, Sathish Srinivasan¹, Evangeline Simon¹

¹Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, Chennai, Tamil Nadu, India.

Laboratory medicine

|November 22, 2025

概括

由维生素K对抗剂-II (PIVKA-II) 诱导的前列红蛋白在诊断肝细胞癌 (HCC) 中具有潜力,特别是在较大的病变和AFP阴性病例中. 然而,其高错误阳性率需要建立特定人群的切断值,以提高诊断准确度.

科学领域:

肝病学肝病学是一种肝病学.
在瘤学瘤学.
生物标志物研究生物标志物研究

背景情况:

肝细胞癌 (HCC) 诊断传统上依赖于高的α-fetoprotein (AFP) 水平和成像.
由维生素K对抗剂-II (PIVKA-II) 诱导的前列红素被评估为HCC的潜在诊断标记物.

研究的目的:

评估PIVKA-II在疑似HCC的印度患者的诊断效用.
为了比较PIVKA-II与AFP在HCC诊断中的疗效.

主要方法:

对178名怀疑患有HCC的印度成年患者进行了回顾性分析.
评估AFP和PIVKA-II水平,并进行放射学调查.
对敏感性,特异性和与瘤大小相关性的分析.

主要成果:

在144名患者 (80.99%) 中诊断出HCC (80.99%).
与AFP相比,PIVKA-II表现出更高的灵敏度 (80.56%),但较低的特异性 (32.35%).
PIVKA-II与HCC大小有中等相关性,对于5厘米以上的病变更可靠;它在68.10%的AFP阴性HCC病例中也升高.

结论:

尽管错误阳性率很高,但PIVKA-II可能有助于诊断较大的HCC病变和AFP阴性病例.
在印度人群中确定PIVKA-II的特定切割值可以提高其诊断特异性.
需要进一步的研究来优化PIVKA-II在HCC诊断和管理中的作用.

关键词:

阿尔法胎儿蛋白 (AFP) 是一种阿尔法胎儿蛋白.肝细胞癌是肝细胞癌.由维生素K对抗剂-II (PIVKA-II) 诱导的前列血栓.

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