A Clinical Study On The Relationship Between Protein Induced By Vitamin K Absence-? And Prognosis In Patients With HCC

Objective:Analyzing the relationship between t Protein Induced by Vitamin K Absence-?(PIVKA-?)and the prognosis of patients with HCC undergoing hepatectomy and its clinical application value.Methods:88 cases with complete clinical data were brought into study,laboratory test data and follow-up data were collected from the Affiliated Hospital of North Sichuan Medical College from August 21,2014 to August 31,2015.The preoperative PIVKA-? concentration,tumor differentiation,tumor size and vascular invasion were analyzed.The survival time of patients was counted by outpatient follow-up and telephone follow-up.Kaplan Meier survival curve was drawn by stata15.1 software to determine the risk factors of overall survival and relapse free survival.Cox risk model was used to analyze the influence of PIVKA-? on survival and prognosis of patients.Results:A total of 88 HCC patients were tested in this research(age:24-80,mean age 54.22±11.420,male to female ratio of 10:1,preoperative PIVKA-? negative group 30 cases,preoperative PIVKA-? positive group 58 cases).Compare preoperative PIVKA ? positive patients with preoperative PIVKA-? negative patients,AFP levels higher,prothrombin time is longer,AST level is lower,differentiation degree is lower and vascular invasion is more often.The results of Kaplan Meier survival curve showed that the 6-month,12-month,18-month,24-month survival rates of PIVKA-? negative group were 88.89%,75.74%,49.01%,25.21%respectively,which were significantly higher than those of PIVKA-?positive group(6-month,12-month,18-month,24-month,79.13%,42.43%,10.19%,2.55%,with a statistically significant difference(?2=4.985,P=0.026);the 6-month,12-month survival rates of PIVKA-? negative group were significantly higher than those of PIVKA-? positive group(6-month,12-month)The relapse free survival rates of 6 months,12 months,18 months and 24 months in PIVKA ? positive group were 81.27%,51.13%,24.26%and 9.10%respectively,with statistical significance(?2=4.444,P=0.035).The primary risk factors for postoperative survival of HCC patients were preoperative AST level,ALP level,alpha fetoprotein level,ALP/ALB value,Protein Induced by Vitamin K Absence-?and the presence of portal vein tumor thrombus.The independent risk factors for postoperative survival were preoperative AST level,preoperative alpha fetoprotein level,preoperative Protein Induced by Vitamin K Absence-?and the presence of portal vein tumor thrombus.The main risk factors of postoperative recurrence in patients with HCC were preoperative AFP level,preoperative Protein Induced by Vitamin K Absence-?and the presence of tumor thrombus in portal vein.The independent risk factors of postoperative recurrence were preoperative Protein Induced by Vitamin K Absence-?.Conclusion:1.Preoperative PIVKA-? concentration is related to the prognosis of HCC patients and can be used as a predictor of postoperative prognosis.The higher the preoperative PIVKA-? concentration,the worse prognosis it would be.