Author/Authors :
Yu، Rentao نويسنده Southwest Hospital,Department of Infectious Diseases,Third Military Medical University,Chongqing,China , , Ding، Shitao نويسنده Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Tan، Wenting نويسنده Southwest Hospital,1Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Tan، Shun نويسنده Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Tan، Zhaoxia نويسنده Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Xiang، Shiqing نويسنده Southwest Hospital,Department of Laboratory Diagnosis,Third Military Medical University,Chongqing,China , , Zhou، Yi نويسنده Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Mao، Qing نويسنده Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China , , Deng، Guohong نويسنده Institute of Immunology, Southwest Hospital,Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases,Third Military Medical University,Chongqing,China ,
Abstract :
Alpha-fetoprotein (AFP) has long been used as an effective biomarker for hepatocellular carcinoma (HCC) screening; however, not all HCC patients can be detected with an elevated AFP level, especially in early HCC patients. Protein Induced by vitamin K absence or antagonistII (PIVKAII) is another serum biomarker linked to HCC; however, sensitivity and specificity remain controversial and data in Chinese groups is even rarer. To evaluate the performance of PIVKAII alone and combined with AFP in HCC screening in Chinese population. This retrospective study enrolled 150 HCC patients in Southwest Hospital, of which 16 patients were excluded due to lack of basic information. A total of 347 patients with hepatitis B, 105 with nonHCC cancers and 53 healthy people were enrolled as controls. Levels of AFP and PIVKAII were measured by chemiluminescence enzyme immunoassay (CLEIA) and chemiluminescent microparticle Immunoassay (CMIA), respectively. The sensitivity and specificity of PIVKAII were 74.6% and 67.8% at a cutoff of 40 mAU/mL and 64.2% and 89.7% at a cutoff of 200 mAU/mL. The sensitivity and specificity of AFP were 76.7% and 65.0% at a cutoff of 20 ng/mL and 60.4% and 88.9% at a cutoff of 195.23 ng/mL. The combination of two markers had a sensitivity and specificity of 91.1% and 41.0%, respectively. The area under the receiving operating curve (AUROC) for PIVKAII (0.756, 95% confidence interval, CI: 0.695 0.816) was less than the AUROC for AFP (0.823, 95% CI: 0.780 0.865), and in combination, the AUROC increased to 0.843 (95% CI: 0.801 0.885). PIVKAII was as efficient as AFP when used as a single marker for HCC screening and the combination of two biomarkers gave a better performance.
