Hongxiang Gao, Chenjie Xie, Jing Wang, Ji Ma, Shijian Liu, Li Xie, Yijie Zheng, Rui Dong, Shan Wang, Yongjun Fang, Yurui Wu, Xianwei Zhang, Xianying Lu, Yang Li, Weisong Li, Qiuhui Pan, Min Xu, Song Gu
{"title":"PIVKA-II 联合甲胎蛋白对儿童肝肿瘤的诊断价值：一项多中心前瞻性观察研究","authors":"Hongxiang Gao, Chenjie Xie, Jing Wang, Ji Ma, Shijian Liu, Li Xie, Yijie Zheng, Rui Dong, Shan Wang, Yongjun Fang, Yurui Wu, Xianwei Zhang, Xianying Lu, Yang Li, Weisong Li, Qiuhui Pan, Min Xu, Song Gu","doi":"10.1007/s12072-024-10668-4","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>To investigate whether protein induced by vitamin K antagonist-II (PIVKA-II) combined with alpha-fetoprotein (AFP) can improve the diagnostic and differential diagnostic accuracy of childhood hepatic tumors.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A multi-center prospective observational study was performed at nine regional institutions around China. Children with hepatic mass (Group T) were divided into hepatoblastoma group (Group T<sub>HB</sub>) and hemangioendothelioma group (Group T<sub>HE</sub>), children with extrahepatic abdominal mass (Group C). Peripheral blood was collected from each patient prior to surgery or chemotherapy. The area under the curve (AUROC) was used to evaluate the diagnostic efficiency of PIVKA-II and the combined tumor markers with AFP.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The mean levels of PIVKA-II and AFP were both significantly higher in Group T than Group C (<i>p</i> = 0.001, <i>p</i> < 0.001), in Group T<sub>HB</sub> than Group T<sub>HE</sub> (p = 0.018, p = 0.013) and in advanced HB than non-advanced HB (p = 0.001, p = 0.021). For the diagnosis of childhood hepatic tumors, AUROC of PIVKA-II (cut-off value 32.6 mAU/mL) and AFP (cut-off value 120 ng/mL) was 0.867 and 0.857. The differential diagnostic value of PIVKA-II and AFP in hepatoblastoma from hemangioendothelioma was further assessed, AUROC of PIVKA-II (cut-off value 47.1mAU/mL) and AFP (cut-off value 560 ng/mL) was 0.876 and 0.743. The combined markers showed higher AUROC (0.891, 0.895 respectively) than PIVKA-II or AFP alone.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The serum level of PIVKA-II was significantly higher in children with hepatic tumors, especially those with malignant tumors. The combination of PIVKA-II with AFP further increased the diagnostic performance.</p><h3 data-test=\"abstract-sub-heading\">Trial registration</h3><p>Clinical Trials, NCT03645655. Registered 20 August 2018, https://www.clinicaltrials.gov/ct2/show/NCT03645655.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":null,"pages":null},"PeriodicalIF":5.9000,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PIVKA-II combined with alpha-fetoprotein for the diagnostic value of hepatic tumors in children: a multicenter, prospective observational study\",\"authors\":\"Hongxiang Gao, Chenjie Xie, Jing Wang, Ji Ma, Shijian Liu, Li Xie, Yijie Zheng, Rui Dong, Shan Wang, Yongjun Fang, Yurui Wu, Xianwei Zhang, Xianying Lu, Yang Li, Weisong Li, Qiuhui Pan, Min Xu, Song Gu\",\"doi\":\"10.1007/s12072-024-10668-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background</h3><p>To investigate whether protein induced by vitamin K antagonist-II (PIVKA-II) combined with alpha-fetoprotein (AFP) can improve the diagnostic and differential diagnostic accuracy of childhood hepatic tumors.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>A multi-center prospective observational study was performed at nine regional institutions around China. Children with hepatic mass (Group T) were divided into hepatoblastoma group (Group T<sub>HB</sub>) and hemangioendothelioma group (Group T<sub>HE</sub>), children with extrahepatic abdominal mass (Group C). Peripheral blood was collected from each patient prior to surgery or chemotherapy. The area under the curve (AUROC) was used to evaluate the diagnostic efficiency of PIVKA-II and the combined tumor markers with AFP.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>The mean levels of PIVKA-II and AFP were both significantly higher in Group T than Group C (<i>p</i> = 0.001, <i>p</i> < 0.001), in Group T<sub>HB</sub> than Group T<sub>HE</sub> (p = 0.018, p = 0.013) and in advanced HB than non-advanced HB (p = 0.001, p = 0.021). For the diagnosis of childhood hepatic tumors, AUROC of PIVKA-II (cut-off value 32.6 mAU/mL) and AFP (cut-off value 120 ng/mL) was 0.867 and 0.857. 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PIVKA-II combined with alpha-fetoprotein for the diagnostic value of hepatic tumors in children: a multicenter, prospective observational study
Background
To investigate whether protein induced by vitamin K antagonist-II (PIVKA-II) combined with alpha-fetoprotein (AFP) can improve the diagnostic and differential diagnostic accuracy of childhood hepatic tumors.
Methods
A multi-center prospective observational study was performed at nine regional institutions around China. Children with hepatic mass (Group T) were divided into hepatoblastoma group (Group THB) and hemangioendothelioma group (Group THE), children with extrahepatic abdominal mass (Group C). Peripheral blood was collected from each patient prior to surgery or chemotherapy. The area under the curve (AUROC) was used to evaluate the diagnostic efficiency of PIVKA-II and the combined tumor markers with AFP.
Results
The mean levels of PIVKA-II and AFP were both significantly higher in Group T than Group C (p = 0.001, p < 0.001), in Group THB than Group THE (p = 0.018, p = 0.013) and in advanced HB than non-advanced HB (p = 0.001, p = 0.021). For the diagnosis of childhood hepatic tumors, AUROC of PIVKA-II (cut-off value 32.6 mAU/mL) and AFP (cut-off value 120 ng/mL) was 0.867 and 0.857. The differential diagnostic value of PIVKA-II and AFP in hepatoblastoma from hemangioendothelioma was further assessed, AUROC of PIVKA-II (cut-off value 47.1mAU/mL) and AFP (cut-off value 560 ng/mL) was 0.876 and 0.743. The combined markers showed higher AUROC (0.891, 0.895 respectively) than PIVKA-II or AFP alone.
Conclusions
The serum level of PIVKA-II was significantly higher in children with hepatic tumors, especially those with malignant tumors. The combination of PIVKA-II with AFP further increased the diagnostic performance.
Trial registration
Clinical Trials, NCT03645655. Registered 20 August 2018, https://www.clinicaltrials.gov/ct2/show/NCT03645655.
期刊介绍：
Hepatology International is the official journal of the Asian Pacific Association for the Study of the Liver (APASL). This is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal will focus mainly on new and emerging technologies, cutting-edge science and advances in liver and biliary disorders.
Types of articles published:
-Original Research Articles related to clinical care and basic research
-Review Articles
-Consensus guidelines for diagnosis and treatment
-Clinical cases, images
-Selected Author Summaries
-Video Submissions
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