title: Serum and tissue PIVKA-II expression reflect the biological malignant potential of small hepatocellular carcinoma.
abstract: A sensitive method for measuring the serum level of protein-induced by vitamin K absence or antagonist II (PIVKA-II) has become so widely available that it is now used for the clinical diagnosis of small hepatocellular carcinoma (HCC). It is known that serum PIVKA-II can be a prognostic indicator for HCC, but there have been no detailed investigations concerning the tissue expression of PIVKA-II. The present study assessed the relationship between serum or tissue PIVKA-II and the biological malignant potential of HCC. The subjects were 25 patients with histologically confirmed HCC, that were solitary and 3 cm or less in diameter. Tissue PIVKA-II was detected by immunostaining using MU-3 as the primary antibody. The biological malignant potential of the tumors was evaluated on the basis of the Ki-67 labeling index of HCC cells and the tumor arterial vascularity assesed by angiography and CO(2) enhanced ultrasonography. The recurrence-free period after treatment was also evaluated. Among the 25 patients, eight were positive for tissue PIVKA-II. Serum PIVKA-II levels were significantly higher in the tissue PIVKA-II-positive patients compared with the negative patients, but serum and tissue PIVKA-II expressions were not consistently parallel. Tumor cell proliferation was closely correlated with the tissue PIVKA-II expression, while the recurrence-free period was correlated with the serum PIVKA-II level. Tumor arterial vascularity showed a strong correlation with the expression of both serum and tissue PIVKA-II. In conclusion, serum and tissue PIVKA-II expression reflect the biological malignant potential of HCC and thus may be useful indicators for the prognosis of small HCC.
authors.affiliation: Department of Gastroenterology, Dokkyo University School of Medicine, Mibu, 321-0293, Tochiogi, Japan
authors.forename: Masaya
authors.initials: M
authors.lastname: Tamano
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sugaya
authors.forename: Motoo
authors.initials: M
authors.lastname: Oguma
authors.forename: Makoto
authors.initials: M
authors.lastname: Iijima
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoneda
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Murohisa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kojima
authors.forename: Toru
authors.initials: T
authors.lastname: Kuniyoshi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Majima
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Terano