ASSOCIATION OF PIVKA II WITH HEPATOCELLULAR CARCINOMA

Abstract

Primary liver tumours are significantly influenced by hepatocellular carcinoma, a diverse liver disease. Clinically, this carcinoma presents with obstructive jaundice, pyogenic liver abscess, and hepatic encephalopathy in addition to variceal or intraperitoneal hemorrhage. In hepatocellular cancer, metastasis outside liver frequently in the lung, abdominal lymph nodes, bone, and adrenal glands. The prevalence of HCC in Pakistan is estimated to be between 3.7% and 16.7%. Exposure to aflatoxin B, hepatitis B or C viruses’ infections (HBV or HCV), and alcoholic cirrhosis are the major factors in the HCC development. In Pakistan the causes of HCC such as hepatitis B and hepatitis C virus are common therefore it is a potential burden. Alpha fetoprotein is used as biomarker for detection of HCC, but its specificity and sensitivity are less and also its level is increased in other liver disease. Current diagnostic tools for HCC suffer from a lack of practical and acceptable biomarkers with high specificity and sensitivity. Therefore, it is critical to investigate potential new biomarkers for HCC that can improve the precision of early diagnosis and improve the chances of successful outcomes. Through a comparative cross sectional study conducted over the course of six months, 55 subjects were included in the study who were diagnosed with hepatocellular carcinoma. Subjects ranged in age from 18 to 65 years old and male or female has been included in the study. Blood samples of the patients were taken and then stored in the laboratory. AFP and PIVKA II levels in the serum were then analyzed by enzyme-linked immunoassay (ELISA). PIVKA II sensitivity and specificity with the alpha fetoprotein has been compared through ROC curve. The sensitivity of PIVKA II was 79.4% and specificity was 72.9% at the level of >40m AU/ml. the sensitivity of AFP was 75.7% and specificity was 71.5% at the level of 10ng/ml. a combination of PIVKA II and AFP give the sensitivity of 80.3% and specificity of 75.2. % sensitivity and specificity of PIVKA II was more in HCC cases as compared to alpha viii fetoprotein. Hence it was concluded that the sensitivity and specificity of protein induced vitamin K since II (PIVKA II) is higher than the Alpha Fetoprotein (AFP).