Abstract
The clinical significance of PIVKA-II measurement was evaluated in 70 cases of hepatocellular carcinoma (HCC). Positive rates for PIVKA-II and a-fetoprotein (AFP) before treatment were 42.9% and 65.7%, respectively. There was no significant correlation between these markers (R=-0.014). Furthermore, the positive rate was increased to 81.4% by a combination assay. The positive rate of PIVKA-II showed strong correlation with both tumor size and macroscopic stage according to the general rules for the clinical and pathological study of primary liver cancer (p<0.05). There was a tendency for positive correlation, however, without statistical significance, between PIVKA-II positivity and histological findings, including grade of anaplasia, capsule invasion, vascular invasion and intrahepatic metastasis, which were regarded as prognostic factors. The positive rates of prognostic factors in PIVKA-II negative and positive patients with HCC of less than 2 cm in diameter were 50% (7/14) and 100% (2/2), respectively. The rates of resectable HCC in PIVKA-II negative and positive patients were 91.3% (21/23) and 66.7% (10/15), respectively. Disease free interval after hepatectomy in PIVKA-II positive patients was significantly shorter than that in PIVKA-II negative patients (p<0.05). In conclusion, PIVKA-II was a reliable marker for detecting HCC, and the combined assay with AFP gave a higher correct diagnostic rate. PIVKA-II was useful in monitoring the progression of HCC, and PIVKA-II positive patients had poor prognosis.
