Y. Tanaka et al., Sensitive measurement of serum abnormal prothrombin (PIVKA-II) as a markerof hepatocellular carcinoma, HEP-GASTRO, 46(28), 1999, pp. 2464-2468
BACKGROUND/AIMS: The usefulness of abnormal prothrombin (PIVKA-II) for diag
nosis of small HCC has been limited by its low sensitivity, despite a high
specificity.
METHODOLOGY: The serum concentration of PIVKA-II was determined by using a
new sensitive enzyme immunoassay (EIA) kit in patients with hepatocellular
carcinoma (I-ICC), liver cirrhosis (LC), or chronic hepatitis(CH) and norma
l controls (NC). alpha-Fetoprotein (AFP) was simultaneously determined in s
ame patients.
RESULTS: This kit has made it possible to detect low concentrations of PIVK
A-II in the NC. The serum PIVKA-II concentration (mean +/-SE) was 15.7+/-1.
1mAu/ml, 16.1+2.0mAu/ml, 26.3+/-7.2mAu/ml and 5420.3+/-3960.0mAu/ml in NC,
CH, LC and HCC, respectively. Among 106 patients with HCC, 74 patients (69.
8%) were positive for PIVKA-II (greater than or equal to 40mAu/ml), while o
nly 9 patients out of 68 patients with LC were positive (13.2%) and only 2
out of 90 patients with CH were positive (2.2%). No significant correlation
was observed between AFP and PIVKA-II levels. With combined assay of AFP a
nd PIVKA-II, the positive rate for HCC was increased to 78.3%. Among 14 pat
ients with HCC <20mm in diameter, 7 were positive for PIVKA-II, and 6 out o
f 10 patients with HCC between 20 and 30mm in diameter were positive for PI
VKA-II. There was a correlation between tumor size and the PIVKA-II level.
CONCLUSIONS: Determination of PIVKA-II by this new EIA kit could be useful
for the diagnosis of HCC, especially combined with determination of AFP.