异常凝血酶原在肝细胞肝癌诊断中的临床价值

肝细胞肝癌是我国常见的恶性肿瘤之一,是指由肝细胞或肝内胆管细胞发生的癌肿,死亡率高1]。肝细胞肝癌的病因和发病机理尚未明确,起病隐匿,病情发展迅速,早期手术切除是最有效的治疗方法1-2]。异常凝血酶原(protein induced by vitamin K absence or antagonist-Ⅱ,PIVKA-Ⅱ)是指由于维生素K缺乏或者由于服用维生素K拮抗剂而产生的异常蛋白质。PIVKA-Ⅱ是凝血Ⅱ因子(凝血酶原)的PIVKA体,因此也被称为异常凝血酶原。

Diagnostic value of PIVKA-II in Hepatocellular Carcinoma

Objective To investigate the diagnostic value of single and combined detection of PIVKA-II and serum alpha-fetoprotein ( AFP) in hepatocellular carcinoma (HCC) and liver cirrhosis.Methods A total of 45 patients with hepatocellular carcinoma and 36 patients with liver cirrhosis diagnosed in Hangzhou First People''s Hospital, Affiliated to Zhejiang University School of Medicine from November 2020 to March 2021, as well as 40 healthy subjects during the same period were collected. The serum levels of PIVKA-II and AFP were determined by chemiluminescence immunoassay.One-way anOVA was used to compare the mean values between the three groups, and correlation analysis was performed between the two variables.At the same time, the receiver operating characteristic (ROC) curve is constructed and the area under ROC curve is analyzed. AUC) to evaluate the diagnostic efficacy of PIVKA-II alone and in combination with AFP for HCC. Results Serum PIVKA-II levels in HCC patients were significantly different from those in healthy subjects (P < 0.05) .The PIVKA-II level of HCC patients was significantly different from that of liver cirrhosis patients(P < 0.05).There was no significant differences between the patients with liver cirrhosis patients and healthy subjects(P > 0.05).When the PIVKA-II cut-off value was 47.715mAU/mL, the AUC for diagnosing HCC was 0.884, 95% CI 0.815-0.953;When the AFP cut-off value was 4.35ug/l, the AUC for diagnosing HCC was 0.787, 95% CI 0.690-0.883;The AUC of PIVKA-II + AFP for the diagnosis of HCC was 0.901, 95% CI 0.838-0.963, The sensitivity and specificity of the combined detection of PIVKA-II and AFP were 75.6% and 95.0%.Conclusion Serum PIVKA-II can be used as a specific indicator for the diagnosis of HCC, and can also be used for the differential diagnosis of HCC and liver cirrhosis.Serum PIVKA-II combined with serum AFP detection can further improve the diagnostic efficiency of HCC, which is conducive to improving the early diagnosis of HCC patients.Early detection of HCC patients can provide the most favorable treatment time for clinical treatment.