The role of PIVKAII oncomarker in hepatocellular carcinoma: А literature review

Abstract

Relevance: Hepatocellular carcinoma (HCC) ranks sixth among the most common malignant neoplasms in the world and accounts for about 5.6% of all human malignant neoplasms. Despite encouraging progress in the diagnosis and treatment of HCC, the prognosis remains unsatisfactory, i.e., with a 5-year overall survival rate below 10.3%. However, the survival rate can reach 50-74% if early detection and therapeutic intervention are carried out on time. However, unfortunately, about 50% of HCC cases are diagnosed at a late stage. The protein induced by the absence of vitamin K or antagonist-II (PIVKA-II), also known as Dez-γ-carboxyprothrombin (DCP), is another marker specific to HCC. In several studies, elevated PIVKA-II serum levels were associated with HCC. Many authors have proven the PIVKA-II applicability for HCC monitoring.
This study aimed to compare the efficiency of alpha-fetoprotein and des-gamma-carboxyprothrombin serological markers in HCC.
Methods: The study included the review of published articles on the causes of HCC and the analysis of literature to compare cancer markers efficacy, including PIVKA-II and alpha-fetoprotein (AFP), in detecting HCC.
Results: The published results evidence an important role of PIVKA-II in HCC early detection since PIVKA-II elevation in risk-group patients predicts HCC development in two years. Higher PIVKA-II levels can indicate a bigger tumor or a higher clinical stage. Besides, HCC patients with metastasis to the lymph nodes and distant metastasis had much higher PIVKA-II levels compared to non-metastatic patients. So, high PIVKA-II levels can, to a certain extent reflect poor prognosis in HCC patients.
Conclusion: The reviewed publications report much higher PIVKA-II serum levels in patients with HCC compared to patients with benign liver diseases or healthy people. Besides, PIVKA-II has a higher diagnostic capacity than AFP due to its higher levels, sensitivity, and specificity. Thus, we can expect high sensitivity and efficiency of the PIVKA-II oncomarker in HCC early diagnostics.