title: Des-gamma-carboxy prothrombin identified by P-11 and P-16 antibodies reflects prognosis for patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Serum des-γ-carboxy prothrombin (DCP) is an established tumor marker in patients with hepatocellular carcinoma (HCC), which can be identified by using MU-3 antibody. The MU-3 antibody mainly reacts with the 9-10 glutamic acid residues of DCP (conventional DCP). Since other variants of DCP with fewer glutamic acid residues can be detected using P-11 and P-16 antibodies (code name: NX-PVKA), we examined the clinical characteristics associated with NX-PVKA, and whether NX-PVKA is a useful measure in HCC patients.
  
  
  METHODS
  Participants comprised 197 HCC patients admitted to our hospital between 2001 and 2010. NX-PVKA, conventional DCP, alpha-fetoprotein, and L3 fraction of alpha-fetoprotein were measured prior to initiation of HCC treatment.
  
  
  RESULTS
  Of the tumor markers assessed, NX-PVKA was the only significant predictor of prognosis (hazard ratio, 81.32; P < 0.0001). Patients with NX-PVKA level ≥ 100 mAU/mL showed significantly lower survival rates (P < 0.0001). NX-PVKA level was also significantly associated with platelet count, prothrombin time, C-reactive protein, sex, maximum tumor size, number of nodules, and portal venous invasion by HCC. Finally, using NX-PVKA level and other clinical parameters, we established a prognostic model to estimate patient survival time.
  
  
  CONCLUSIONS
  NX-PVKA offers the best marker of tumor prognosis among HCC patients, and is strongly associated with tumor factors and hepatic functional reserve. NX-PVKA could be useful for clinical evaluation of tumor severity, as well as the estimated duration of survival among patients with HCC.
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeji
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Yohei
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Seijin
authors.initials: S
authors.lastname: Nadano
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000276:immunology*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011498:Protein Precursors / Q000276:immunology*; D011516:Prothrombin / Q000276:immunology*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin