Diagnostic performance of PIVKA-II in identifying recurrent hepatocellular carcinoma following curative resection: a retrospective cohort study.

Shijie Jiang, Xiaolong Chen, Weilong Wang, Xiaowen Wang, Wenjie Zheng, Ping Xue, Hua Li, Wenfeng Zhu, Juping Xie, Haoqi Chen, Shuguang Zhu, Xiaofeng Jiang, Genshu Wang

Journal: Scientific reports 2024;14(1):8416

PMID: 38600210

Free Full Text on Nature Publishing Group View on PubMed

Abstract

Protein induced by vitamin K absence or antagonist II (PIVKA-II) plays a critical role in the diagnosis of hepatocellular carcinoma (HCC), however, studies on its efficacy in diagnosing recurrent HCC were rarely found. A multicenter, retrospective, and observational study was conducted. During the overall follow-up of 5 years, HCC patients who had curative resection were monitored every 3 months in the first year post-surgery and every 6 months thereafter if no recurrence occurred. Tumor markers were collected at the diagnosis of recurrence for those with recurrence and at the last follow-up for those without recurrence. The median serum levels of PIVKA-II and AFP in the recurrence group were significantly higher than those in the non-recurrence group (PIVKA-II: 84.62 vs. 18.76 mAU/ml, p < 0.001; AFP: 4.90 vs. 3.00 ng/ml, p < 0.001) and there is a significant correlation between PIVKA-II and AFP (R = 0.901, p < 0.001). PIVKA-II showed better accuracy than AFP in the diagnosis of overall recurrent HCC (AUC: 0.883 vs. 0.672; p < 0.0001), but also in patients with negative PIVKA-II before curative resection (AUC: 0.878 vs. 0.680, p = 0.001). Clinician should pay more attention to serum PIVKA-II values when following patients after curative HCC resection to detect early recurrence.Clinical trial registration: ChiCTR2300070874.

Address: Department of Hepatic Surgery, Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.; Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.; Department of General Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510630, China.; Department of General Surgery, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518000, China.; Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510630, China.; Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510630, China. [email protected].; Department of Hepatic Surgery, Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China. [email protected].; State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, 510630, China. [email protected].; Department of Liver Transplantation, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 510630, China. [email protected].; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510630, China. [email protected].; Chinese Medicine Guangdong Laboratory (Hengqin Laboratory), Hengqin, 519031, China. [email protected].

DOI: 10.1038/s41598-024-59174-5

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MeSH Terms: Humans, Carcinoma, Hepatocellular, Retrospective Studies, Liver Neoplasms, alpha-Fetoproteins, Biomarkers, Prothrombin, Biomarkers, Tumor, Protein Precursors