title: Clinical utility of protein induced by vitamin K absence in patients with chronic hepatitis B virus infection.
abstract: Hepatitis B virus (HBV) is a leading cause of hepatocellular carcinoma (HCC). α-fetoprotein (AFP) is a common tumor marker for the diagnosis of HCC, although not for protein induced by the absence of vitamin K or antagonist-II (PIVKA-II). The present study aimed to evaluate the role of PIVKA-II in the diagnosis of HCC in HBV-infected Vietnamese patients. A total of 166 consecutive HBV-infected Vietnamese patients were enrolled, including 41 HCC, 43 liver cirrhosis (LC), 26 chronic hepatitis (CH) and 56 asymptomatic carriers (ASC). AFP was examined using ELISA, while PIVKA-II was analyzed using Eitest PIVKA-II. The cut-off level of AFP and PIVKA-II was 20 ng/ml and 40 mAU/ml, respectively. Although the markers, AFP (344±356 ng/ml) and PIVKA-II (16,200±25,386 mAU/ml), were the highest in the HCC groups, only PIVKA-II in HCC was significantly higher compared to the other groups (P<0.001). The univariate analysis demonstrated that age over 50, male, genotype C, AFP and PIVKA-II were risk factors of LC and HCC. Results of the receiver operating characteristics (ROC) analysis showed that PIVKA-II was more sensitive to HCC compared to AFP. Moreover, PIVKA-II was strongly correlated with the portal venous thrombosis in HCC, as opposed to AFP. Results of the multivariate analysis demonstrated that PIVKA-II was the strongest independent risk factor of LC and HCC. In conclusion, PIVKA-II is likely to be a better marker for the diagnosis of HCC in chronic HBV-infected Vietnamese patients.
authors.affiliation: Vinmec International Hospital; ; Department of Gastroenterology;
authors.forename: Bui Xuan
authors.initials: BX
authors.lastname: Truong
authors.affiliation: Department of Gastroenterology; ; Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan ;
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Departments of Microbiology, and.
authors.forename: Vu Tuong
authors.initials: VT
authors.lastname: VAN
authors.affiliation: Department of Gastroenterology;
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Seo
authors.affiliation: Gastroenterology, Bach Mai Hospital, Hanoi, Vietnam ;
authors.forename: Nguyen Hoai
authors.initials: NH
authors.lastname: Nam
authors.affiliation: Gastroenterology, Bach Mai Hospital, Hanoi, Vietnam ;
authors.forename: Nguyen Khanh
authors.initials: NK
authors.lastname: Trach
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan ; ; Indonesia-Japan Collaborative Research Center for Emerging and Reemerging Infectious Diseases, Research Institute for Tropical Medicine, Airlangga University, Surabaya, Indonesia.
authors.forename: Takako
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Gastroenterology;
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan ;
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
keywords: Vietnam; hepatitis B virus; hepatocellular carcinoma; protein induced by vitamin K absence or antagonist-II