[Determination of PIVKA-II levels in patients with small hepatocellular carcinoma--comparison of new sensitive methods].
Current EIA for PIVKA-II is not sensitive enough to detect small Hepatocellular Carcinoma (HCC). In an attempt to increase the diagnostic threshold, the current EIA was modified in two different ways: 1) immunoreaction of PIVKA-II in the sample with its monoclonal antibody was carried out overnight at 5 degrees C instead of for two hours at room temperature (the overnight method), 2) Avidin-Biotin technique was used for the second reaction(the ABC method);and their diagnostic values were determined as compared with the current EIA(2hr method) in a total of 138 patients including 36 patients with HCC. In 27 patients with HCC(< 3 cm in diameter), the rates of abnormal values obtained by the 2hr-, the overnight- and the ABC method were 14.8, 25.9 and 29.6% respectively. False positive rates of these three methods in 69 patients with liver cirrhosis were 1.4, 8.6 and 22.9% respectively. Thus, these two modifications improved the sensitivity of the current EIA and the overnight method appears to be superior to the ABC method in terms of specificity and simplicity. This conclusion was confirmed by ROC analysis.
Ishijima
M
M
Clinical Laboratory, Tsukuba University Hospital, Japan.
Nomura
F
F
Horikoshi
A
A
Ohnishi
K
K
Nakai
T
T
D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000097:blood*; D011498:Protein Precursors / Q000378:metabolism*; D011516:Prothrombin / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin