title: Diagnostic role and correlation with staging systems of PIVKA-II compared with AFP.
abstract: OBJECTIVE
  Alpha-fetoprotein (AFP) and protein-induced by vitamin K absence or antagonist (PIVKA-II) are representative markers of hepatocellular carcinoma (HCC). The aim of this study was to evaluate the usefulness of PIVKA-II when compared with AFP for detecting HCC. Furthermore, we evaluated the correlation between PIVKA-II and HCC staging.
  
  
  METHODS
  One hundred patients with liver cirrhosis (LC) and 227 with HCC were analyzed between January 2004 and March 2006. To compare the diagnostic value of PIVKA-II and AFP, Receiver operating characteristic curve was constructed.
  
  
  RESULTS
  The area under the curve indicated a better accuracy for PIVKA-II than AFP in diagnosis of HCC (0.829 vs. 0.712). The positive rates of PIVKA-II in patients with tumor size larger than 5 cm, 3-5 cm, and less than 3 cm were higher than that of AFP (96%, 83%, 74% vs. 65%, 57%, 48%, respectively). In addition, there seems to be correlation between PIVKA-II and staging systems, Tumor Node Metastasis, Cancer of the Liver Italian Program score and Japan Integrated Staging score (p<0.05).
  
  
  CONCLUSIONS
  The results of this study show that a PIVKA-II is a useful marker for detecting HCC, especially in small HCC and may have correlations with known staging systems.
authors.affiliation: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Yang-Hyun
authors.initials: YH
authors.lastname: Baek
authors.forename: Jong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Jang
authors.forename: Sung-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Han
authors.forename: Jin-Sook
authors.initials: JS
authors.lastname: Jeong
authors.forename: Jong-Chul
authors.initials: JC
authors.lastname: Choi
authors.forename: Ha-Youn
authors.initials: HY
authors.lastname: Kim
authors.forename: Sang-Young
authors.initials: SY
authors.lastname: Han
mesh_terms: D015415:Biomarkers / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: C097353:AFP protein, human; D015415:Biomarkers; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin