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Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population

BACKGROUND: Alpha-fetoprotein (AFP) has long been used as an effective biomarker for hepatocellular carcinoma (HCC) screening; however, not all HCC patients can be detected with an elevated AFP level, especially in early HCC patients. Protein Induced by vitamin K absence or antagonist-II (PIVKA-II)...

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Autores principales: Yu, Rentao, Ding, Shitao, Tan, Wenting, Tan, Shun, Tan, Zhaoxia, Xiang, Shiqing, Zhou, Yi, Mao, Qing, Deng, Guohong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539732/
https://www.ncbi.nlm.nih.gov/pubmed/26300931
http://dx.doi.org/10.5812/hepatmon.28806v2
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author Yu, Rentao
Ding, Shitao
Tan, Wenting
Tan, Shun
Tan, Zhaoxia
Xiang, Shiqing
Zhou, Yi
Mao, Qing
Deng, Guohong
author_facet Yu, Rentao
Ding, Shitao
Tan, Wenting
Tan, Shun
Tan, Zhaoxia
Xiang, Shiqing
Zhou, Yi
Mao, Qing
Deng, Guohong
author_sort Yu, Rentao
collection PubMed
description BACKGROUND: Alpha-fetoprotein (AFP) has long been used as an effective biomarker for hepatocellular carcinoma (HCC) screening; however, not all HCC patients can be detected with an elevated AFP level, especially in early HCC patients. Protein Induced by vitamin K absence or antagonist-II (PIVKA-II) is another serum biomarker linked to HCC; however, sensitivity and specificity remain controversial and data in Chinese groups is even rarer. OBJECTIVES: To evaluate the performance of PIVKA-II alone and combined with AFP in HCC screening in Chinese population. PATIENTS AND METHODS: This retrospective study enrolled 150 HCC patients in Southwest Hospital, of which 16 patients were excluded due to lack of basic information. A total of 347 patients with hepatitis B, 105 with non-HCC cancers and 53 healthy people were enrolled as controls. Levels of AFP and PIVKA-II were measured by chemiluminescence enzyme immunoassay (CLEIA) and chemiluminescent microparticle Immunoassay (CMIA), respectively. RESULTS: The sensitivity and specificity of PIVKA-II were 74.6% and 67.8% at a cutoff of 40 mAU/mL and 64.2% and 89.7% at a cutoff of 200 mAU/mL. The sensitivity and specificity of AFP were 76.7% and 65.0% at a cutoff of 20 ng/mL and 60.4% and 88.9% at a cutoff of 195.23 ng/mL. The combination of two markers had a sensitivity and specificity of 91.1% and 41.0%, respectively. The area under the receiving operating curve (AUROC) for PIVKA-II (0.756, 95% confidence interval, CI: 0.695 - 0.816) was less than the AUROC for AFP (0.823, 95% CI: 0.780 - 0.865), and in combination, the AUROC increased to 0.843 (95% CI: 0.801 - 0.885). CONCLUSIONS: PIVKA-II was as efficient as AFP when used as a single marker for HCC screening and the combination of two biomarkers gave a better performance.
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spelling pubmed-45397322015-08-21 Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population Yu, Rentao Ding, Shitao Tan, Wenting Tan, Shun Tan, Zhaoxia Xiang, Shiqing Zhou, Yi Mao, Qing Deng, Guohong Hepat Mon Research Article BACKGROUND: Alpha-fetoprotein (AFP) has long been used as an effective biomarker for hepatocellular carcinoma (HCC) screening; however, not all HCC patients can be detected with an elevated AFP level, especially in early HCC patients. Protein Induced by vitamin K absence or antagonist-II (PIVKA-II) is another serum biomarker linked to HCC; however, sensitivity and specificity remain controversial and data in Chinese groups is even rarer. OBJECTIVES: To evaluate the performance of PIVKA-II alone and combined with AFP in HCC screening in Chinese population. PATIENTS AND METHODS: This retrospective study enrolled 150 HCC patients in Southwest Hospital, of which 16 patients were excluded due to lack of basic information. A total of 347 patients with hepatitis B, 105 with non-HCC cancers and 53 healthy people were enrolled as controls. Levels of AFP and PIVKA-II were measured by chemiluminescence enzyme immunoassay (CLEIA) and chemiluminescent microparticle Immunoassay (CMIA), respectively. RESULTS: The sensitivity and specificity of PIVKA-II were 74.6% and 67.8% at a cutoff of 40 mAU/mL and 64.2% and 89.7% at a cutoff of 200 mAU/mL. The sensitivity and specificity of AFP were 76.7% and 65.0% at a cutoff of 20 ng/mL and 60.4% and 88.9% at a cutoff of 195.23 ng/mL. The combination of two markers had a sensitivity and specificity of 91.1% and 41.0%, respectively. The area under the receiving operating curve (AUROC) for PIVKA-II (0.756, 95% confidence interval, CI: 0.695 - 0.816) was less than the AUROC for AFP (0.823, 95% CI: 0.780 - 0.865), and in combination, the AUROC increased to 0.843 (95% CI: 0.801 - 0.885). CONCLUSIONS: PIVKA-II was as efficient as AFP when used as a single marker for HCC screening and the combination of two biomarkers gave a better performance. Kowsar 2015-07-22 /pmc/articles/PMC4539732/ /pubmed/26300931 http://dx.doi.org/10.5812/hepatmon.28806v2 Text en Copyright © 2015, Kowsar Corp. http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Research Article
Yu, Rentao
Ding, Shitao
Tan, Wenting
Tan, Shun
Tan, Zhaoxia
Xiang, Shiqing
Zhou, Yi
Mao, Qing
Deng, Guohong
Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title_full Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title_fullStr Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title_full_unstemmed Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title_short Performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) for Hepatocellular Carcinoma Screening in Chinese Population
title_sort performance of protein induced by vitamin k absence or antagonist-ii (pivka-ii) for hepatocellular carcinoma screening in chinese population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539732/
https://www.ncbi.nlm.nih.gov/pubmed/26300931
http://dx.doi.org/10.5812/hepatmon.28806v2
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