Clinicopathological Significance of Alpha-fetoprotein and PIVKA-II Measurement in Operated Patients with Hepatocellular Carcinoma

Kazuyuki Takenami, Ken Takasaki, Masakazu Yamamoto, Masashi Tsugita, Atsushi Aruga, Takafumi Suzuki, Takehito Ohtsubo, Hideki Kobayashi and Satoshi Katagiri

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University

The clinical significance of AFP and PIVKA-II measurement was studied in 444 resected hepatocellular carcinomas (HCC). The positive rate was 61.0% for AFP, 36.9% for PIVKA-II and 70.9% for the combination of the two, respectively. No significant correlation was found between serum AFP and plasma PIVKA-II levels; therefore these markers seemed to be complementary. In 130 patients with HCC smaller than 2cm in diameter, the positive rate was 57.7% for AFP and 10.0% for PIVKA-II, respectively, these findings indicate that elevation of plasma PIVKA-II was more rarely found than that of serum AFP in small HCC. Correlation between AFP, PIVKA-II and the clinicopathological factors was analyzed by Spearman's rank correlation test. Significant correlations were observed between AFP and vp, differentiation, and im, whereas there were significant correlations between PIVKA-II and stage, vp, im, fc-inf, maximal tumor diameter, and differentiation. The survival rate after the operation was significantly lowest in the highest plasma PIVKA-II group, as well as in the highest serum AFP group. The multivariate analysis by Cox's proportional hazard model, using stepwise regression analysis, suggested that plasma PIVKA-II levels, as well as vp and im, would be some of the most important prognostic factors.

Key words
hepatocellular carcinoma, AFP, PIVKA-II, multivariate analysis, prognostic factor

Reprint requests
Kazuyuki Takenami Department of Surgery, Instututl of Gastroenterology, Tokyo Woman's Medical University 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JAPAN

Accepted
September 22, 1999

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