title: Clinical characteristics and prognosis of hepatocellular carcinoma with different sets of serum AFP and PIVKA-II levels.
abstract: OBJECTIVE
  α-Fetoprotein (AFP) and prothrombin induced by the absence of vitamin K or antagonist-II (PIVKA-II) are useful tumor markers for hepatocellular carcinoma (HCC). However, little is known about the clinical characteristics and prognosis of HCC with different levels of AFP and PIVKA-II.
  
  
  METHODS
  Consecutive 1447 HCC patients were assigned to four groups according to the cutoff values of AFP (400 ng/ml) and PIVKA-II (100 mAU/ml): both values high (AP), one of the values high (Ap and aP), and both values low (ap). The clinical characteristics and the prognosis of group ap were compared with those of the other groups.
  
  
  RESULTS
  HCC patients in group ap were more asymptomatic at diagnosis, and had smaller size, fewer numbers, and earlier stages of HCC, and more preserved liver functions (all, P<0.001). The survival rate of group ap was significantly higher than those of the other groups (P<0.001). In multivariate analysis, the combined status of AFP and PIVKA-II values were independent predictors for survival (P<0.001), together with tumor size, number, portal vein thrombosis, Child-Pugh class, and treatment modality.
  
  
  CONCLUSIONS
  HCC patients with low values of both AFP and PIVKA-II had more favorable clinical characteristics and showed a better prognosis than those with elevated levels of AFP or PIVKA-II.
authors.affiliation: Department of Internal Medicine, Yonsei University College, Seoul, Korea.
authors.forename: Se Hun
authors.initials: SH
authors.lastname: Kang
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Soung Min
authors.initials: SM
authors.lastname: Jeon
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Kwan Sik
authors.initials: KS
authors.lastname: Lee
authors.forename: Chae Yoon
authors.initials: CY
authors.lastname: Chon
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D009367:Neoplasm Staging; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin