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Clinical usefulness of double biomarkers AFP and PIVKA-II for subdividing prognostic groups in locally advanced hepatocellular carcinoma

 Hana Park  ;  Seung Up Kim  ;  Jun Young Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Kwang-Hyub Han  ;  Jinsil Seong 
 LIVER INTERNATIONAL, Vol.34(2) : 313-321, 2014 
Journal Title
Issue Date
Adult ; Aged ; Analysis of Variance ; Area Under Curve ; Biomarkers/blood* ; Carcinoma, Hepatocellular/classification ; Carcinoma, Hepatocellular/diagnosis* ; Female ; Humans ; Liver Neoplasms/classification ; Liver Neoplasms/diagnosis* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Protein Precursors/blood* ; Prothrombin ; Republic of Korea ; Survival Analysis ; Tomography, X-Ray Computed ; Ultrasonography ; alpha-Fetoproteins/analysis*
Alpha-foetoprotein ; hepatocellular carcinoma ; prothrombin induced by the absence of vitamin K or antagonist-II ; tumour response
BACKGROUND & AIMS: In this study, we investigated the clinical usefulness of AFP and PIVKA-II in subdividing prognostic groups in patients with locally advanced HCC treated locally. METHODS: Patients who had undergone local treatment for locally advanced HCC between 2001 and 2006 were enrolled. Response to treatment was defined as a reduction in AFP or PIVKA-II by more than 50% from baseline levels at 1 month after the treatment completion. Patients were divided according to their AFP and PIVKA-II response: A↓P↓ [AFP response (+) and PIVKA-II response (+)]; A↓P↑ [AFP response (+) and PIVKA-II response (-)]; A↑P↓ [AFP response (-) and PIVKA-II response (+)]; A↑P↑ [AFP response (-) and PIVKA-II response (-)]. Clinical characteristics and prognosis were compared between groups. RESULTS: Patients were subdivided into four groups by the change in the level of the biomarkers AFP and PIVKA-II, and the survival outcomes of each group were distinct. Among patients with an AFP response, further subdivision by PIVKA-II response revealed that those in the A↓P↓ group had a longer median progression-free survival (PFS) and overall survival (OS) compared with those in the A↓P↑ group (PFS: 16.2 vs. 5.1 months, P = 0.009; OS: 26.3 vs. 7.3 months, P = 0.017). Combination of AFP and PIVKA-II response showed a predictive power for PFS and OS comparable to radiological criteria and better than AFP response alone. CONCLUSIONS: In patients with locally advanced HCC, the use of a combination of two biomarkers, AFP and PIVKA-II, appears useful in predicting treatment outcomes through the subdivision of prognostic groups.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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