The influence of alcoholic liver disease on serum PIVKA-II levels in patients without hepatocellular carcinoma

Keunhee Kang, Ji Hoon Kim, Seong Hee Kang, Beom Jae Lee, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Jong Jae Park, Jae Seon Kim, Young Tae Bak, Kwan Soo Byun

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)

    Abstract

    Background/Aims: 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. Methods: 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). Results: 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. Conclusions: 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.

    Original languageEnglish
    Pages (from-to)224-230
    Number of pages7
    JournalGut and liver
    Volume9
    Issue number2
    DOIs
    Publication statusPublished - 2015 Mar 1

    Keywords

    • Hepatocellular carcinoma
    • Liver diseases, alcoholic
    • Prothrombin induced by vitamin K deficiency or antagonist II

    ASJC Scopus subject areas

    • Hepatology
    • Gastroenterology

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