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Nanashima A, Sumida Y, Tobinaga S, et al. Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis. HPB (Oxford). 2006;8(2):137-41doi: 10.1080/13651820500273475.
Nanashima, A., Sumida, Y., Tobinaga, S., Shibata, K., Shindo, H., Obatake, M., Shibasaki, S., Ide, N., & Nagayasu, T. (2006). Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis. HPB : the official journal of the International Hepato Pancreato Biliary Association, 8(2), 137-41. https://doi.org/10.1080/13651820500273475
Nanashima, A, et al. "Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis." HPB : the official journal of the International Hepato Pancreato Biliary Association vol. 8,2 (2006): 137-41. doi: https://doi.org/10.1080/13651820500273475
Nanashima A, Sumida Y, Tobinaga S, Shibata K, Shindo H, Obatake M, Shibasaki S, Ide N, Nagayasu T. Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis. HPB (Oxford). 2006;8(2):137-41. doi: 10.1080/13651820500273475. PMID: 18333262; PMCID: PMC2131417.
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HPB (Oxford). 2006;8(2):137-41. doi: 10.1080/13651820500273475.

Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis.

HPB : the official journal of the International Hepato Pancreato Biliary Association

A Nanashima, Y Sumida, S Tobinaga, K Shibata, H Shindo, M Obatake, S Shibasaki, N Ide, Takeshi Nagayasu

Affiliations

  1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

PMID: 18333262 PMCID: PMC2131417 DOI: 10.1080/13651820500273475

Abstract

BACKGROUND: alpha-Fetoprotein (AFP) has been used as a marker for hepatocellular carcinoma (HCC). However, AFP levels are often high in patients with chronic hepatitis or cirrhosis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is more sensitive for the diagnosis of HCC and prediction of patient survival. Changes in these markers after treatment may reflect treatment curability and patient outcome.

METHODS: We conducted a retrospective analysis of prognosis of 63 HCC patients with high preoperative levels of AFP and PIVKA-II who underwent hepatectomy and examined the relationship between postoperative changes in both markers at 1 month and patient survival. Subjects were divided into three groups according to changes in these tumour markers after hepatectomy: normalization (N) group, decreased but still above the normal level (D) group and unchanged (U) group.

RESULTS: There were no significant differences in the numbers of patients who developed tumour recurrence between changes in AFP and PIVKA-II. Survival analysis showed no significant differences in tumour-free and overall survivals between groups with respect to AFP level. The PIVKA-II-N group showed significantly better tumour-free and overall survival compared with the D and U groups (p<0.01). Multivariate analysis that included other prognostic factors identified changes in PIVKA-II level as a significant and independent prognostic factor associated with overall survival.

DISCUSSION: Although changes in AFP did not correlate with patient prognosis, normalization of PIVKA-II was significantly associated with good patient survival after hepatectomy. Normalization of PIVKA-II after hepatectomy reflected the efficacy of treatment and is a suitable predictor of prognosis in HCC patients.

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