Open AccessThe diagnostic value of PIVKA‐II, AFP, AFP‐L3, CEA, and their combinations in primary and metastatic hepatocellular carcinoma
Author(s) -
Qi Famei,
Zhou Aihua,
Yan Li,
Yuan Xiumei,
Wang Danni,
Chang Ruoyun,
Zhang Yujun,
Shi Funa,
Han Xiaomei,
Hou Jinxia,
Wei Lianhua,
Zhang Xu
Publication year - 2020
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23158
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , carcinoma
Abstract Background Early diagnosis decreases the mortality of hepatocellular carcinoma (HCC). We aimed to investigate the usefulness of PIVKA‐II, AFP, AFP‐L3, CEA, and their combinations in the diagnosis of primary and metastatic HCC. Methods One hundred and twenty patients with primary HCC (PHC), 115 with metastatic HCC (MHC), 89 with chronic liver disease (CLD), and 116 healthy volunteers were included. The diagnostic values of each marker and their combinations for HCC diagnosis were represented by ROC curve analyses. Results PIVKA‐II, AFP, and AFP‐L3 levels in PHC group were higher than that in normal control, CLD, and MHC groups. CEA levels in MHC group were higher than that in the other three groups. When the four markers were analyzed individually, PIVKA‐II showed the highest positive rate in PHC group (76.7%) and CEA showed the highest positive rate in MHC group (69.6%). PIVKA‐ II showed the largest area under ROC curve (AUC = 0.835) to discriminate PHC group from CLD group. Combined PIVKA‐II with AFP‐L3 increased the AUC to 0.910. CEA showed the highest AUC (0.849) to discriminate MHC group from CLD group. Combined CEA with PIVKA‐II increased the AUC to 0.866. AFP‐L3 alone showed the highest AUC (0.890) to discriminate MHC group from PHC group. Combined PIVKA‐II with AFP‐L3, and CEA increased the AUC to 0.957. Conclusion PIVKA‐II, AFP‐L3, AFP, and CEA are effective biomarkers for the diagnosis of PHC and MHC. Their combinations could improve the diagnostic performance compared with each marker used alone in detecting PHC and MHC.