"PIVKA-II combined with alpha-fetoprotein for the diagnostic value of hepatic tumors in children: a multicenter, prospective observational study"

作者全名："Gao, Hongxiang; Xie, Chenjie; Wang, Jing; Ma, Ji; Liu, Shijian; Xie, Li; Zheng, Yijie; Dong, Rui; Wang, Shan; Fang, Yongjun; Wu, Yurui; Zhang, Xianwei; Lu, Xianying; Li, Yang; Li, Weisong; Pan, Qiuhui; Xu, Min; Gu, Song"

作者地址："[Gao, Hongxiang; Xie, Chenjie; Wang, Jing; Xu, Min; Gu, Song] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Pediat Gen Surg, Dongfang Rd 1678, Shanghai 200127, Peoples R China; [Ma, Ji; Pan, Qiuhui] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Lab Med, Shanghai 200127, Peoples R China; [Liu, Shijian] Shanghai Jiao Tong Univ, Child Hlth Advocacy Inst, Shanghai Childrens Med Ctr, Sch Med, Shanghai 200127, Peoples R China; [Xie, Li] Shanghai Jiao Tong Univ, Sch Med, Clin Res Inst, Shanghai 200025, Peoples R China; [Zheng, Yijie] Wuxidiagnotics, Dept Med Affairs, Shanghai 200131, Peoples R China; [Dong, Rui] Fudan Univ, Dept Pediat Surg, Childrens Hosp, Shanghai 201102, Peoples R China; [Wang, Shan] Chongqing Med Univ, Dept Pediat Surg Oncol, Childrens Hosp, Chongqing 400014, Peoples R China; [Fang, Yongjun] Nanjing Med Univ, Dept Hematol & Oncol, Childrens Hosp, Nanjing 210008, Peoples R China; [Wu, Yurui] Shandong Univ, Dept Minimally Invas Surg, Qilu Childrens Hosp, Jinan 250022, Shandong, Peoples R China; [Zhang, Xianwei] Zhengzhou Univ, Dept Oncol Surg, Childrens Hosp, Zhengzhou 450018, Peoples R China; [Lu, Xianying] Anhui Prov Childrens Hosp, Dept Pediat Surg, Hefei 230051, Peoples R China; [Li, Yang] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Pediat Hematol Oncol, Guangzhou 519000, Peoples R China; [Li, Weisong] Anhui Med Univ, Dept Gen Surg, Pediat Surg, Affiliated Hosp 1, Hefei 230022, Peoples R China"

通信作者："Xu, M; Gu, S (通讯作者)，Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Pediat Gen Surg, Dongfang Rd 1678, Shanghai 200127, Peoples R China."

来源：HEPATOLOGY INTERNATIONAL

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001202395300001

JCR分区：Q1

影响因子：5.9

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Alpha-fetoprotein; Biomarker; Children; Diagnostic; Hemangioendothelioma; Hepatic tumor; Hepatoblastoma; Histopathology; Protein induced by vitamin K antagonist-II; Malignant tumor

摘要："Background To investigate whether protein induced by vitamin K antagonist-II (PIVKA-II) combined with alpha-fetoprotein (AFP) can improve the diagnostic and differential diagnostic accuracy of childhood hepatic tumors. Methods A multi-center prospective observational study was performed at nine regional institutions around China. Children with hepatic mass (Group T) were divided into hepatoblastoma group (Group T-HB) and hemangioendothelioma group (Group T-HE), children with extrahepatic abdominal mass (Group C). Peripheral blood was collected from each patient prior to surgery or chemotherapy. The area under the curve (AUROC) was used to evaluate the diagnostic efficiency of PIVKA-II and the combined tumor markers with AFP. Results The mean levels of PIVKA-II and AFP were both significantly higher in Group T than Group C (p = 0.001, p < 0.001), in Group T-HB than Group T-HE (p = 0.018, p = 0.013) and in advanced HB than non-advanced HB (p = 0.001, p = 0.021). For the diagnosis of childhood hepatic tumors, AUROC of PIVKA-II (cut-off value 32.6 mAU/mL) and AFP (cut-off value 120 ng/mL) was 0.867 and 0.857. The differential diagnostic value of PIVKA-II and AFP in hepatoblastoma from hemangioendothelioma was further assessed, AUROC of PIVKA-II (cut-off value 47.1mAU/mL) and AFP (cut-off value 560 ng/mL) was 0.876 and 0.743. The combined markers showed higher AUROC (0.891, 0.895 respectively) than PIVKA-II or AFP alone. Conclusions The serum level of PIVKA-II was significantly higher in children with hepatic tumors, especially those with malignant tumors. The combination of PIVKA-II with AFP further increased the diagnostic performance."

基金机构：Project of Shanghai Science and Technology Committee

基金资助正文：We would like to thank the study participants.