Diagnostic performance of protein induced by vitamin K absence II for chronic hepatitis B-related hepatocellular carcinoma

Jianxin Wan, Jiachun Su, Zhuangjian Ye, Chumei Huang, Jianbo Liang, Min Liu, Jinmei Luo, Laisheng Li


Background: The aim of this study was to assess the diagnostic value of prothrombin induced by vitamin K absence-II (PIVKA-II) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) in a Chinese population.
Methods: In this study, receiver operating characteristics (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated to assess the diagnostic performance of serum PIVKA-II levels for HBV-related HCC (n=134) with negative or mildly elevated α-fetoprotein (AFP) relative to chronic hepatitis B (CHB, n=119) patients or healthy controls (n=100).
Results: Serum levels of PIVKA-II were significantly greater in the HBV-related HCC patients compared to the CHB patients (P<0.05). A Mann-Whitney U test showed that there was a trend toward higher levels of serum PIVKA-II with increasing stages of the CHB-related HCC subjects, and a significant correlation between PIVKA-II levels and HCC pathological characteristics including tumor size, portal vein thrombosis, and tumor metastasis (P<0.05). Of the study subjects with AFP <20 ng/mL, the AUC value was 0.790 for PIVKA-II in distinguishing between HBV-related HCC and CHB, with a sensitivity of 65.3% and a specificity of 94.9%. Moreover, among the study subjects with AFP of 20–200 ng/mL, the value of AUC for PIVKA-II in discriminating HBV-related HCC from CHB was 0.775, with a sensitivity of 60.0% and a specificity of 98.3%.
Conclusions: PIVKA-II shows high discriminatory ability and improvement of the detection rate for HBV-related HCC in a Chinese population with normal or mildly elevated AFP.