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. 2023 Jun 15;13(6):2588-2597.
eCollection 2023.

High PIVKA-II level and ASAP score predict 1-year risk of hepatocellular carcinoma in non-cirrhotic chronic hepatitis B patients

Yi-Cheng Lu  1 , Tung-Hung Su  2   3 , Tai-Chung Tseng  2   3   4 , Shih-Jer Hsu  2 , Sih-Han Liao  5 , Chun-Ming Hong  6 , Chen-Hua Liu  2 , Hung-Chih Yang  2 , Chun-Jen Liu  2   3 , Jia-Horng Kao  2   3   4
Affiliations

High PIVKA-II level and ASAP score predict 1-year risk of hepatocellular carcinoma in non-cirrhotic chronic hepatitis B patients

Yi-Cheng Lu et al. Am J Cancer Res. .

Abstract

Protein induced by Vitamin K absence or antagonists-II (PIVKA-II) is a diagnostic marker of hepatocellular carcinoma (HCC). We aimed to investigate the predictive role of PIVKA-II and ASAP score for development of HCC in 1 year among untreated patients of chronic hepatitis B (CHB). We conducted this case-control study to include untreated CHB patients followed at the National Taiwan University Hospital and grouped into HCC and matched non-HCC groups. Their archived serum samples were assayed for PIVKA-II levels 1 year before HCC, at HCC or their last serum sample. A total of 69 HCC cases and 102 non-HCC controls were recruited. Baseline PIVKA-II level was significantly higher in the HCC group than in the control group and it could predict HCC development in 1 year with an area under the receiver operating characteristic curve of 0.76. Multivariable analysis adjusting age, sex, liver function and alpha-fetoprotein level showed that baseline PIVKA-II ≥31 mAU/mL (vs. <31 mAU/mL) increased 12.5-fold risk (95% CI: 4.9-31.7) of HCC in 1 year, and even in patients with normal alpha-fetoprotein levels. The ASAP score, a combination of age, sex, alpha-fetoprotein and PIVKA-II, increases the predictability for HCC in 1 year. We concluded that both high PIVKA-II level and ASAP score may predict HCC development in 1 year in untreated CHB patients, especially in patients with normal alpha-fetoprotein level.

Keywords: DCP; Des-gamma-carboxy prothrombin; HCC; Protein induced by vitamin K absence or antagonists-II; biomarker; liver cancer; tumor marker.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
The receiver operating characteristic (ROC) curve of PIVKA-II for predicting HCC in 1 year.
Figure 2
Figure 2
The receiver operating characteristic (ROC) curve of PIVKA-II for predicting HCC in 1 year in patients with AFP <20 ng/mL.
Figure 3
Figure 3
The receiver operating characteristic (ROC) curve of ASAP score for predicting HCC in 1 year.
Figure 4
Figure 4
Using ASAP score 0.31 for HCC prediction in 1 year.
See this image and copyright information in PMC

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