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NX-PVKA levels before and after hepatectomy of hepatocellular carcinoma as predictors of patient survival: a preliminary evaluation of an improved assay for PIVKA-II.

Abstract
Although the protein-induced vitamin K absence or antagonist-II (PIVKA-II) is used as a prognostic marker in hepatocellular carcinoma (HCC), a newly-improved assay, NX-PVKA (PIVKA-II measured using P-11 and P-16 antibodies) and NX-PVKA-R (ratio of PIVKA-II and NX-PVKA), are more accurate markers of PIVKA-II. We conducted a prospectively preliminary analysis of the relationship between NX-PVKA-R and clinicopathological parameters and prognosis in 22 patients with HCC who underwent hepatectomy and measured changes of this marker's levels after treatment. Median value of PIVKA-II (80 mAU/ml), NX-PVKA (60 mAU/ml), NX-PVKA-R (1.5) and NX-PVKA-D (difference of markers, 15 mAU/ml) were determined. Tumor relapse was observed in six patients, and the one year relapse-free survival rate was 88%. Correlation between PIVKA-II or alpha-fetoprotein levels and NX-PVKA, NX-PVKA-R or -D levels was significant (p<0.001). NX-PVKA-R was significantly correlated with tumor size (p<0.05). In patients who underwent pre-treatment before hepatectomy, PIVKA-II, NX-PVKA and NX-PVKA-R tended to be higher than in patients without pre-treatment, but this difference was not significant (p>0.10). For macroscopic findings, NX-PVKA-R for the confluent-nodular type was significantly higher than that for the simple-nodular type (p<0.05). The tumor-free survival rate in the group with a high NX-PVKA-R was significantly lower than that in the group with a low NX-PVKA-R group (p<0.05). In patients with tumor recurrence, postoperative NX-PVKA-R increased again. We conclude that a high value of NX-PVKA-R after hepatectomy for HCC reflects malignant potential and predicts early recurrence in patients with HCC.
AuthorsAtsushi Nanashima, Takafumi Abo, Naota Taura, Hideki Shibata, Tatsuki Ichikawa, Katsunori Takagi, Junichi Arai, Shousaburou Oyama, Takeshi Nagayasu
JournalAnticancer research (Anticancer Res) Vol. 33 Issue 6 Pg. 2689-97 (Jun 2013) ISSN: 1791-7530 [Electronic] Greece
PMID23749928 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
  • Biomarkers, Tumor
  • Protein Precursors
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin
Topics
  • Aged
  • Aged, 80 and over
  • Biomarkers (analysis)
  • Biomarkers, Tumor (analysis)
  • Carcinoma, Hepatocellular (chemistry, mortality, surgery)
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms (chemistry, mortality, surgery)
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Protein Precursors (analysis, immunology)
  • Prothrombin (analysis, immunology)
  • Survival Rate
  • alpha-Fetoproteins (analysis)

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