The Influence of Alcoholic Liver Disease on Serum PIVKA-II Levels in Patients Without Hepatocellular Carcinoma

Overview

Journal Gut Liver

Specialty Gastroenterology

Date 2014 Dec 5

PMID 25473073

Citations 13

Authors

Keun Hee Kang

Ji Hoon Kim

Seong Hee Kang

Beom Jae Lee

Yeon Seok Seo

Hyung Joon Yim

Jong Eun Yeon

Jong Jae Park

Jae Seon Kim

Young Tae Bak

Kwan Soo Byun

Affiliations

Soon will be listed here.

Abstract

Background/aims: Prothrombin induced by vitamin K defi-ciency or antagonist II (PIVKA-II) is a widely used diagnostic marker for hepatocellular carcinoma (HCC). We evaluated the correlation between alcoholic liver disease (ALD) and serum PIVKA-II levels in chronic liver disease (CLD) patients.

Methods: We retrospectively reviewed the medical records of 2,528 CLD patients without HCC. Among these patients, 76 exhibited serum high PIVKA-II levels of >125 mAU/mL (group 1). We categorized 76 control patients matched by age, sex, and the presence of liver cirrhosis from the remain-ing patients who were negative for serum PIVKA-II (group 2).

Results: Group 1 revealed increased antibiotic usage (23.7% vs 2.6%, p<0.001) and incidence of ALD (60.5% vs 14.5%, p<0.001) as well as elevated aspartate aminotransferase (52.5 IU/L vs 30.5 IU/L, p=0.025) and γ glutamyl transpepti-dase (67.5 IU/L vs 36.5 IU/L, p=0.005) levels compared with group 2. Further, group 1 was significantly associated with a worse Child-Pugh class than group 2. In the multivariate anal-ysis, ALD (odds ratio [OR], 7.151; p<0.001) and antibiotic us-age (OR, 5.846; p<0.001) were significantly associated with positive PIVKA-II levels.

Conclusions: Our study suggests that ALD and antibiotics usage may be confounding factors when interpreting high serum PIVKA-II levels in patients without HCC. Therefore, serum PIVKA-II levels in patients with ALD or in patients administered antibiotics should be interpreted with caution. (Gut Liver, 2015;9224-230).

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