Clinical utility of protein induced by vitamin K absence in patients with chronic hepatitis B virus infection

Truong,Bui  Xuan; Yano,Yoshihiko; Van,Vu  Tuong; Seo,Yasushi; Nam,Nguyen   Hoai; Trach,Nguyen  Khanh; Utsumi,Takako; Azuma,Takeshi; Hayashi,Yoshitake

doi:10.3892/br.2012.4

Clinical utility of protein induced by vitamin K absence in patients with chronic hepatitis B virus infection

Authors:
- Bui Xuan Truong
- Yoshihiko Yano
- Vu Tuong Van
- Yasushi Seo
- Nguyen Hoai Nam
- Nguyen Khanh Trach
- Takako Utsumi
- Takeshi Azuma
- Yoshitake Hayashi
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Affiliations: Vinmec International Hospital, Hanoi, Vietnam, Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan, Department of Microbiology, Bach Mai Hospital, Hanoi, Vietnam, Department of Gastroenterology, Bach Mai Hospital, Hanoi, Vietnam, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
Published online on: August 24, 2012 https://doi.org/10.3892/br.2012.4
Pages: 122-128

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Abstract

Hepatitis B virus (HBV) is a leading cause of hepatocellular carcinoma (HCC). α-fetoprotein (AFP) is a common tumor marker for the diagnosis of HCC, although not for protein induced by the absence of vitamin K or antagonist‑II (PIVKA-II). The present study aimed to evaluate the role of PIVKA-II in the diagnosis of HCC in HBV‑infected Vietnamese patients. A total of 166 consecutive HBV‑infected Vietnamese patients were enrolled, including 41 HCC, 43 liver cirrhosis (LC), 26 chronic hepatitis (CH) and 56 asymptomatic carriers (ASC). AFP was examined using ELISA, while PIVKA-II was analyzed using Eitest PIVKA-II. The cut-off level of AFP and PIVKA-II was 20 ng/ml and 40 mAU/ml, respectively. Although the markers, AFP (344±356 ng/ml) and PIVKA-II (16,200±25,386 mAU/ml), were the highest in the HCC groups, only PIVKA-II in HCC was significantly higher compared to the other groups (P<0.001). The univariate analysis demonstrated that age over 50, male, genotype C, AFP and PIVKA-II were risk factors of LC and HCC. Results of the receiver operating characteristics (ROC) analysis showed that PIVKA-II was more sensitive to HCC compared to AFP. Moreover, PIVKA-II was strongly correlated with the portal venous thrombosis in HCC, as opposed to AFP. Results of the multivariate analysis demonstrated that PIVKA-II was the strongest independent risk factor of LC and HCC. In conclusion, PIVKA-II is likely to be a better marker for the diagnosis of HCC in chronic HBV‑infected Vietnamese patients.

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