维生素K缺乏或拮抗剂Ⅱ诱导蛋白与肝细胞癌关系研究进展

Correlation of protein induced by vitamin K absence or antagonist-Ⅱ with hepatocellular carcinoma

我国肝细胞癌发病率逐年上升,甲胎蛋白是诊断肝细胞癌的常用血清学标志物,其诊断肝细胞癌的灵敏度为39%~65%、特异度为76%~94%。维生素K缺乏或拮抗剂Ⅱ诱导蛋白(protein induced by vitamin K absence or antagonist-Ⅱ,PIVKA-Ⅱ)是因维生素K缺乏诱生的异常凝血酶原,在肝细胞癌患者血清和组织中表达明显升高。PIVKA-Ⅱ诊断肝细胞癌的灵敏度为48%~62%,特异度为81%~98%,PIVKA-Ⅱ和甲胎蛋白联合检测诊断肝细胞癌的灵敏度为68%~87%,特异度为60%~88%。PIVKA-Ⅱ可预测肝细胞癌微血管浸润及治疗后复发情况。本文就PIVKA-Ⅱ与肝细胞癌关系的研究进展作一综述。

Hepatocellular carcinoma(HCC)is a common malignant tumor in China,with increasing incidence year by year.Alpha fetoprotein is the most common serologic biomarker for the diagnosis of HCC,with the sensitivity of 39% to 65% and the specificity of 76% to 94%.Protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)is an abnormal prothrombin which is induced by the lack of vitamin K,with significantly high concentration in the serum and tissue of HCC patients.PIVKA-Ⅱ has a sensitivity of 48% to 62% and a specificity of 81%to 98%for the diagnosis of HCC.The diagnosis sensitivity and specificity of the combination detection of alpha fetoprotein and PIVKA-Ⅱis 68% to 87% and 60% to 88% respectively.In addition,PIVKA-Ⅱ can predict microvascular invasion and recurrence of HCC patients.This paper reviews the research progress of the correlation between PIVKA-Ⅱ and HCC.