THE VALUE OF COMBINED DETECTION OF PIVKA-II, AFP AND AFP-L3 IN THE DIAGNOSIS OF HEPATOCELLULAR CARCINOMA

YONGJIE PAN*, JINHUA DAI*, XIN HUA*, JUNFENG CHEN*, YANMIN CHEN*, YUFENG LIAO*

*Ningbo Second Hospital, Laboratory

Introduction: To study the clinical value of serum abnormal prothrombin (PIVKA-II), serum alpha-fetoprotein (AFP) and alpha-fetoprotein heterogene (AFP-L3) in the diagnosis of hepatocellular carcinoma (HCC).

Methods: 125 HCC patients admitted to the central hospital of Shandong Provincial Hospital of Shandong University from January 2005 to January 2009 were selected as HCC group, 86 patients with cirrhosis were cirrhosis group, and 94 patients with hepatitis B were hepatitis group. Another 100 healthy subjects were selected as healthy controls group. The levels of PIVKA-II, AFP and AFP-L3 in all subjects were tested and compared.

Results: The levels of serum PIVKA-II, AFP and AFP-L3 in HCC group were significantly higher than those in liver cirrhosis group, hepatitis group and healthy control group. The difference was statistically significant (P<0.05). The area of PIVKA-II, AFP, and AFP-L3 under the receiver operating characteristic curves in the HCC group were 0.917, 0.852, and 0.827, respectively. In the single test, PIVKA-II had the highest sensitivity and accuracy of 80.8% and 90.7%, AFP-L3 had the highest specificity of 91.4%. In the combined test, the combination of PIVKA-II+AFP-L3 and PIVKA-II+AFP+AFP-L3 was the highest specificity, which was 93.6%, the combination of PIVKA-II/AFP/AFP-L3 was the highest sensitivity, which was 94.4%.

Conclusion: The combined detection of PIVKA-II, AFP and AFP-L3 can improve the diagnostic efficiency of HCC and make up for the deficiency of single detection.