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Prognostic values of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II in hepatitis B virus-related hepatocellular carcinoma: a prospective study
- Source :
- Journal of clinical gastroenterology. 43(5)
- Publication Year :
- 2009
-
Abstract
- Background/Aim: Alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-Il (PIVKA-II) are most widely used tumor markers in detecting hepatocellular carcinoma (HCC). Recently, there have been some studies about them as prognostic markers in hepatitis C virus-associated HCC. However, prognostic values of AFP and PIVKA-II remain clarified in hepatitis B virus (HBV)-associated HCC. This study was aimed to evaluate the prognostic values of AFP and PIVKA-II in HBV-associated HCC. Methods: Patients (n = 126) were divided into 4 groups according to median levels of AFP and PIVKA-II (L; low/low, A; high/low, P; low/high, H; high/high) at diagnosis. Clinical characteristics and survival were compared among the groups, and Cox regression analysis was performed to find independent factors for survival. Results: Baseline host and viral factors were not significantly different among the 4 groups. High PIVKA-II groups (P and H) had more aggressive tumor characteristics (larger size of tumors, higher number of tumors, frequent portal vein thrombosis, P < 0.05) and much shorter median survival time than low PIVKA-II groups (L and A) (P < 0.05). In multivariate analysis, high PIVKA-II level was an independent predictor for survival (risk ration: 2.377, 95% confidence interval: 1.359-4.157, P = 0.002) together with Child-Pugh score, advanced TMN stages, and treatment modality. Even after excluding 33 patients who had Child-Pugh class C and advanced tumor stages (tumor-nodesmetastasis stage III-IV) at diagnosis, high PIVKA-II level was still an independent predictor for survival (risk ration: 4.258, 95% confidence interval: 2.418-8.445, P < 0.001). Conclusions: Serum PIVKA-II level, not serum AFP, was a valuable independent prognostic factor in HBV-related HCC.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pathology
Carcinoma, Hepatocellular
Kaplan-Meier Estimate
medicine.disease_cause
Gastroenterology
Risk Assessment
Young Adult
Orthohepadnavirus
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Carcinoma
Humans
Prospective Studies
Protein Precursors
Aged
Neoplasm Staging
Proportional Hazards Models
Hepatitis B virus
Aged, 80 and over
biology
business.industry
Liver Neoplasms
Hepatitis C
Middle Aged
medicine.disease
biology.organism_classification
Hepatitis B
digestive system diseases
Confidence interval
Treatment Outcome
Hepadnaviridae
Hepatocellular carcinoma
Female
Prothrombin
alpha-Fetoproteins
Alpha-fetoprotein
business
Biomarkers
Subjects
Details
- ISSN :
- 15392031
- Volume :
- 43
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of clinical gastroenterology
- Accession number :
- edsair.doi.dedup.....895e6608c66033c371fbccd38fcaceb2