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PIVKA-II: A New Biomarker for the Diagnosis of Liver Cancer (HCC)

Thu, 22 Aug 2024

PIVKA-II: A New Biomarker for the Diagnosis of Liver Cancer (HCC)
 

Background

Hepatocellular carcinoma (HCC) is one of the most common malignant cancers of the digestive system, with high morbidity and mortality rates. Early diagnosis is crucial for timely treatment and improving the survival chances of patients. Although imaging techniques such as ultrasonography and MRI have enhanced the accuracy of HCC diagnosis, their high cost and invasive nature limit their use. Therefore, the search for inexpensive, non-invasive, and repeatable serum biomarkers is essential in the diagnosis of HCC.
 

PIVKA-II and AFP

Prothrombin induced by vitamin K absence or antagonist-II (PIVKA-II) has been identified as a potential biomarker for HCC. PIVKA-II can complement α-fetoprotein (AFP), a widely used biomarker that has limitations, particularly in detecting small and early-stage tumors.
 

Research Methods

This study involved 168 HCC patients, 150 patients with benign liver diseases, and 153 healthy controls. Serum levels of PIVKA-II were measured and compared using enzyme-linked immunosorbent assay (ELISA). ROC curve analysis was used to evaluate the diagnostic value of PIVKA-II and its role in complementing AFP. The relationship between PIVKA-II levels and clinicopathological characteristics was also analyzed to assess the value of PIVKA-II in predicting the progression and prognosis of HCC. Additionally, comparisons of PIVKA-II levels before and after surgery were conducted on 89 HCC patients to evaluate the curative effects of surgical resection.
 

Research Results

Serum levels of PIVKA-II in HCC patients were significantly higher compared to patients with benign liver diseases and healthy controls. The performance of PIVKA-II as an individual biomarker for diagnosing HCC was very good. Combined detection of PIVKA-II and AFP improved the diagnostic efficiency of HCC, especially in AFP-negative HCC patients.

A significant relationship was found between PIVKA-II levels and several clinicopathological characteristics, including tumor size, tumor stage, tumor metastasis, differentiation degree, and complications. After surgery, PIVKA-II expression significantly decreased, indicating that PIVKA-II can be used to evaluate the curative effects of surgical resection.
 

Conclusion

PIVKA-II is a promising serum biomarker for the diagnosis of HCC and can be used to complement AFP. The combined diagnosis of both markers significantly improves the diagnostic efficiency of HCC. PIVKA-II levels in HCC patients are closely related to clinicopathological characteristics representing tumor cell spread and/or poor prognosis. PIVKA-II can be used to evaluate the curative effects of HCC resection.
 

Author: Dr. Kemas Yakub Rahadiyanto, Sp.PK, M.KES (Head Doctor at Medical Laboratory Ahmad Dahlan Palembang)

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