The Clinical Utility Of PIVKA-Ⅱ In Evaluation Of The Short-term Efficacy Of Tace In Patients With Hepatocellular Carcinoma

Objective This study explored and analyzed the clinical utility of PIVKA-Ⅱin evaluation of the short-term efficacy of TACE in patients with hepatocellular carcinoma.Methods Patients who were clinically diagnosed as HCC and initially seropositive for PIVKA-Ⅱ(≥40.00m AU/ml)after conventional TACE in Zhongda Hospital,Southeast University from December 2018 to October 2019 were retrospectively reviewed.Serologic response and radiologic response(m RECIST guidelines)were compared and analyzed at the 1,3 and 6 months after TACE respectively.A Spearman correlation analysis was used to investigate the correlation of serologic response and radiologic response.The paired chi-square test(Mc Nemar test)was used to analyze the consistency of sensitivity of the serologic response and radiologic response.Regarding radiologic response as the gold standard,the validity and reliability indicators of serologic response were analyzed.Results A total of 114 patients were included in this study,the value of PIVKA-Ⅱwas766.11(116.93-6325.91)m AU/ml.At 1,3 and 6 months after TACE,104(91.2%),94(90.3%)and 86(90.5%)patients were classified as positive serologic response groups,whereas 103(90.3%),90(86.5%)and 82(86.3%)patients were classified as positive radiologic response groups,respectively.A Spearman correlation analysis showed that the radiologic response was significantly correlated with the serologic response(t=11.603,10.832 and 9.665,r_s=0.739,0.731 and 0.708,all P<0.001).The paired chi-square test(Mc Nemar test)showed that the sensitivity of the two assessment methods were relatively consistent(χ2=0,1.5 and 1.5,P values at 1,3 and6 months were 1.000,0.219 and 0.219 respectively and all P were>0.05).The validity and reliability indicators were all maintained at a relatively high level.Conclusion PIVKA-Ⅱis clinically valuable in terms of monitoring short-term efficacy for HCC after TACE,which could be complementary to radiologic response evaluation.