Page 120 - GPD-3-4

Gene & Protein in Disease

ORIGINAL RESEARCH ARTICLE
Application of multiple inflammatory markers

combined with PIVKA-II in differential diagnosis
of AFP-NHCC

1†
4,6
Wen-Tan Hu , Xin-Ying Ji 2,3† , Zhi-Liang Jiang 4,5 , Yi Liu , Huang-Yin Luo 5 ,
1
1
1
De-Xin Zhang , Yi-Bin Lu , and Ning Luo *
1 Xinyang Central Hospital, Xinyang, Henan, China

Abstract
Alpha-fetoprotein (AFP) is a proven blood biomarker widely used in clinical
detection of liver cancer, and its concentration increases immediately after liver
injury, with high diagnostic specificity and low sensitivity. However, in patients
with AFP-negative hepatocellular carcinoma (AFP-NHCC), also known as small
liver cancer, their early stage of AFP expression is usually low or close to the
normal range. Compared with AFP-positive HCC, AFP-NHCC is more likely to be
subjected to missed diagnosis due to solely dependence on the measurement of
blood AFP. Therefore, it is necessary to find a reliable, effective, and economical
detection method for the early diagnosis of AFP-NHCC. PIVKA-II is closely related
to the occurrence, development, invasion, and metastasis of liver cancer, and is
† These authors contributed equally also a new hematological marker widely used in the diagnosis of liver cancer in
to this work. recent years. PIVKA-II effectively makes up for the limitation of negative AFP. 63.2%
*Corresponding author: – 76.3% of patients with negative AFP showed positive PIVKA-II, and if only PIVKA-II
Ning Luo detection was relied on, there would still be missed diagnosis in early patients
(luoning0376@163.com) with AFP-NHCC. In this retrospective study, we selected several commonly used
Citation: Hu W, Ji X, Jiang Z, et al. inflammatory indicators to explore the diagnostic efficacy of PIVKA-II, an abnormal
Application of multiple inflammatory form of prothrombin, combined with inflammatory indicators in patients with
markers combined with PIVKA-II in
differential diagnosis of AFP-NHCC. early-stage AFP-NHCC and analyzed the relationship between some clinical
Gene Protein Dis. 2024;3(4):4269. features and hematological indicators in patients with AFP-NHCC. Serum levels
doi: 10.36922/gpd.4269 of high-sensitivity C-reactive protein (hs-CRP), prealbumin (PA), neutrophil/
Received: July 17, 2024 lymphocyte ratio (NLR), and PIVKA-II were compared among three groups (AFP-
NHCC group, benign lesion group, and healthy subjects). The diagnostic efficacy
Accepted: November 4, 2024
of PIVKA-II alone for AFP-NHCC and the diagnostic efficacy of three inflammatory
Published Online: November 28, indicators combined with PIVKA-II for AFP-NHCC were calculated, and their
2024 diagnostic specificity and sensitivity were compared. Compared with the other two
Copyright: © 2024 Author(s). groups, the AFP-NHCC group showed significant changes in three inflammatory
This is an Open-Access article markers and PIVKA-II, which may be related to the inflammatory progression of
distributed under the terms of the
Creative Commons Attribution the tumor. Therefore, we recommend the establishment of a laboratory-based
License, permitting distribution, detection approach for diagnosing early-stage AFP-NHCC by combining PIVKA-II
and reproduction in any medium, with inflammatory indicators hs-CRP, PA, and NLR, to facilitate diagnosis, treatment,
provided the original work is
properly cited. and prognosis of AFP-NHCC.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Alpha-fetoprotein-negative hepatocellular carcinoma; Prealbumin; PIVKA-II;
regard to jurisdictional claims in
published maps and institutional High-sensitivity C-reactive protein
affiliations.

Volume 3 Issue 4 (2024) 1 doi: 10.36922/gpd.4269