PIVKA-II is a useful tool for diagnostic characterization of ultrasound-detected liver nodules in cirrhotic patients

Autor: Daniele Lombardo, Carlo Saitta, Giuseppina Raffa, Gianluca Tripodi, Santa Brancatelli, Teresa Pollicino, Giovanni Raimondo, Angela Alibrandi
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Liver Cirrhosis
Male
Multivariate analysis
Gastroenterology
Cohort Studies
0302 clinical medicine
Stage (cooking)
HCC
Ultrasonography
Univariate analysis
Ultrasound
Liver Neoplasms
General Medicine
hepatocellular carcinoma
Middle Aged
PIVKA-II
hepatocellular carcinoma
AFP
Liver
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Area Under Curve
030211 gastroenterology & hepatology
Female
Prothrombin
alpha-Fetoproteins
medicine.symptom
Research Article
medicine.medical_specialty
AFP
Observational Study
Diagnosis
Differential
03 medical and health sciences
Internal medicine
PIVKA-II
medicine
Biomarkers
Tumor
Humans
Protein Precursors
Aged
Receiver operating characteristic
business.industry
cirrhosis
Nodule (medicine)
medicine.disease
digestive system diseases
liver nodules
ROC Curve
Multivariate Analysis
business
Biomarkers
Blood sampling
Follow-Up Studies
Zdroj: Medicine
Popis: Protein induced by vitamin K absence-II (PIVKA-II) is a potential screening marker for hepatocellular carcinoma (HCC). Limited data are available about its utility in discriminating neoplastic from regenerative nodules at ultrasonography (US) evaluation in cirrhotic patients. Aim of this study was to investigate the diagnostic utility of PIVKA-II in cases showing liver nodules of uncertain diagnosis at US. Ninety cirrhotics with US evidence of liver nodule(s) were enrolled. All patients underwent blood sampling within 1 week of US and were thereafter followed up. HCC was confirmed in 40/90 cases, and in all cases it was in a very early/early stage. All sera were tested for PIVKA-II and alpha-fetoprotein (AFP) at the end of follow-up. PIVKA-II at a cut off of 60 mAU/mL was significantly associated with HCC at both univariate and multivariate analysis (P = .016 and P = .032, respectively). AFP at a cut off of 6.5 ng/mL was not associated with HCC at univariate analysis (P = .246). ROC curves showed that PIVKA-II had 60% sensitivity, 88% specificity, 80% positive predictive value (PPV), and 73% negative predictive value (NPV), whereas AFP had 67% sensitivity, 68% specificity, 63% PPV, and 72% NPV. AUROC curves showed that the combination of both biomarkers increased the diagnostic accuracy for HCC (AUC 0.76; sensitivity 70%, specificity 94%, PPV 91%, and NPV 79%). In conclusion, PIVKA-II is a useful tool for the diagnostic definition of US-detected liver nodules in cirrhotic patients, and it provides high diagnostic accuracy for HCC when combined with AFP.
Databáze: OpenAIRE
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