Clinical Significance of PIVKA-II Measurement in Patients with Resected Hepatocellular Carcinoma

Toshiyuki Itamoto, Toshimasa Asahara, Kouji Katayama, Shinya Nomura, Seiji Marubayashi, Hiroshi Yahata, Yasuhiko Fukuda, Toshiya Matsuyama, Masayuki Nishiki, Kiyohiko Dohi

Second Department of Surgery, Hiroshima University Medical School

The clinical significance of PIVKA-II measurement was evaluated in 29 cases of resected hepatocellular carcinoma (HCC), compared with that of AFP measured in 106 cases of HCC. Positive rates for PIVKA-II and AFP were 58.6% and 64.2%, respectively before surgery. We found that the PIVKA-II-positive rate increased with tumor size, especially in all patients with tumors greater than 5 cm in diameter. The PIVKA-II-positive rate in patients with small HCC (T≤2 cm) was only 37.5%, but all had portal invasion or intrahepatic metastasis confirmed by histopathological examination. By these findings, we recognized that although the tumor is smaller, it is probably not an early cancer if a high PIVKA-II level has been detected in the course of disease. Our results also showed that 70.6% of the PIVKA-II-positive cases had portal invasion and 49.2% of the AFP-positive cases had that, indicating a significant difference (p<0.01) between both positive rate. Similarly, regarding the factor of capsule invasion, PIVKA-II was also a more sensitive marker than AFP. We conclude that PIVKA-II measurement is a more reliable test for the detection of the degree and the behavior of HCC than the routine AFP test.

Key words
hepatocellular carcinoma, PIVKA-II

Reprint requests
Toshiyuki Itamoto Seond Department of Surgery, Hiroshima University Medical School
1-2-3 Kasumi, Minami-ku, Hiroshima, 734 JAPAN

Accepted
July 3, 1991

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