The Influence of Alcoholic Liver Disease on Serum PIVKA-II Levels in Patients without Hepatocellular Carcinoma
- Kang, Keunhee; Kim, Ji Hoon; Kang, Seong Hee; Lee, Beom Jae; Seo, Yeon Seok; Yim, Hyung Joon; Yeon, Jong Eun; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae; Byun, Kwan Soo
- Issue Date
- 거트앤리버 발행위원회
- Prothrombin induced by vitamin K deficiency or antagonist II; Liver diseases; alcoholic; Hepatocellular carcinoma
- Gut and Liver, v.9, no.2, pp.224 - 230
- Journal Title
- Gut and Liver
- Start Page
- End Page
Prothrombin induced by vitamin K deficiency 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.
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 remaining patients who were negative for serum PIVKA-II (group 2).
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 transpeptidase (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 analysis, ALD (odds ratio [OR], 7.151; p<0.001) and antibiotic usage (OR, 5.846; p<0.001) were significantly associated with positive PIVKA-II levels.
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.
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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