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

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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 Jan 1

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Vitamin K Deficiency
Alcoholic Liver Diseases
Prothrombin
Hepatocellular Carcinoma
Serum
Anti-Bacterial Agents
Liver Diseases
Chronic Disease
Odds Ratio
gamma-Glutamyltransferase
Aspartate Aminotransferases
Liver Cirrhosis
Medical Records
Multivariate Analysis

Keywords

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

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{a261333d37b048da98be4138fda44e48,
title = "The influence of alcoholic liver disease on serum PIVKA-II levels in patients without hepatocellular carcinoma",
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.",
keywords = "Hepatocellular carcinoma, Liver diseases, alcoholic, Prothrombin induced by vitamin K deficiency or antagonist II",
author = "Keunhee Kang and Kim, {Ji Hoon} and Kang, {Seong Hee} and Beomjae Lee and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Park, {Jong Jae} and Kim, {Jae Seon} and Young-Tae Bak and Byun, {Kwan Soo}",
year = "2015",
month = "1",
day = "1",
doi = "10.5009/gnl14047",
language = "English",
volume = "9",
pages = "224--230",
journal = "Gut and Liver",
issn = "1976-2283",
publisher = "Joe Bok Chung",
number = "2",

}

TY - JOUR

T1 - The influence of alcoholic liver disease on serum PIVKA-II levels in patients without hepatocellular carcinoma

AU - Kang, Keunhee

AU - Kim, Ji Hoon

AU - Kang, Seong Hee

AU - Lee, Beomjae

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Park, Jong Jae

AU - Kim, Jae Seon

AU - Bak, Young-Tae

AU - Byun, Kwan Soo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

KW - Hepatocellular carcinoma

KW - Liver diseases, alcoholic

KW - Prothrombin induced by vitamin K deficiency or antagonist II

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U2 - 10.5009/gnl14047

DO - 10.5009/gnl14047

M3 - Article

VL - 9

SP - 224

EP - 230

JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

IS - 2

ER -