The Clinical Significance of PIVKA-II Determination in Patients with Hepatic, Biliary and Pancreatic Diseases

Masato Sakon, Morito Monden, Mitsukazu Gotoh, Toshio Kanai, Kouji Umeshita, Wakio Endoh, Takesada Mori

The Second Department of Surgery, Osaka University Medical School

To investigate the mechanisms involved in the generation of PIVKA-II (protein induced by vitamin K absence or antagonist-Il) in HCC (hepatocellular carcinoma), the amount of vitamin K (K1, MK4, MK7) or PIVKA-II in plasma was measured. The plasma level of vitamin K was not decreased in patients with HCC compared with that in normal subjects; it was increased in patients with liver cirrhosis (VK1, MK4, VKl+MK4+MKZ). The plasma level or positivity rate of PIVKA-II was decreased by the administration of vitamin K. This indicates that the metabolism or availability of vitamin K might be impaired in HCC. In patients with biliary or pancreatic disease, all cases with positive PIVKA-II underwent PTBD (percutaneous transhepatic biliary drainage), indicating that not only vitamin K deficiency but also its impaired metabolism due to obstructive jaundice might account for the synthesis of PIVKA-II. Since the impairment of vitamin K metabolism is considered to be one of the characteristics of HCC, PIVKA-II must be measured without vitamin K administration and if administrated, it should be carefully evaluated considering the effects of vitamin K on PIVKA-II

Key words
hepatocellular carcinoma, PIVKA-II, vitamin K

Reprint requests
Morito Manden The Second Department of Surgery, Osaka University Medical School
1-1-50 Fukushma, Fukushima-ku, Osaka, 553 JAPAN

Accepted
December 13, 1989

To read the PDF file you will need Abobe Reader installed on your computer.