The Expression And Its Significance Of Serum Prothrombin Induced By Vitamin K Absence-Ⅱ(PIVKA-Ⅱ) In PVTT

Objective:To investigate the expression of PIVKA-Ⅱ in HCC and its clinical significance in HCC with portal vein tumor thrombus(PVTT)Methods:A total of 56 patients with newly diagnosed liver cancer,32 with chronic liver disease and 30 healthy controls were enrolled in the study.Kruskal-Wallis H was used to analyze the expression levels of PIVKA-Ⅱ among different groups;the correlations between the expression levels of PIVKA-Ⅱ and the clinical pathological factors in the prognosis of HCC were analyzed;the ROC curve was drawn and used to analyze the predicting performance of HCC and PUTT.Logistic was used to analyze the risk factors of PUTT.The expression of VEGFA in the supernatant of HepG2 cells was measured.Results:The levels of PIVKA-Ⅱ and AFP in HCC patients were higher than those in chronic liver disease and the healthy group(PIVKA-Ⅱ:U= 137.0,187.Orespectively,AFP:U= 323.0,125.0respectively,P<0.01),but the levels of PIVKA-Ⅱ in chronic liver disease was similar to that in healthy individuals(P>0.05).The AUC and specificity of PIVKA-Ⅱwere higher than AFP and the combined specificity was higher than that of single test.The AUC of PIVKA-Ⅱ in the diagnosis of AFP-negative HCC was(0.882,95%CI:0.789-0.945)while sensitivity and specificity were 78.95%and 100%(when the cut-off value was 45.88 mAu/ml).The PIVKA-Ⅱ level was related to the number of nodules,tumor size and severe MVI(P<0.01).The levels of PIVKA-Ⅱ,AFP and VEGFA in PVTT were higher than those of HCC patients without PVTT(U=221.0,185.0 and 187.0,P<0.05).The specificity of PIVKA-Ⅱ was higher than AFP and VEGFA,the level of PIVKA-Ⅱ was an independent predictor of PVTT(OR 23997,95%CI 1.217～7.381,P=0:017).Conclusion:Serum PIVKA-Ⅱ is of high clinical value in the diagnosis of HCC and PVTT,and it may promote the progression of HCC by promoting the expression of VEGFA,which may provide a laboratory basis for the treatment of PIVKA-II as a target.