PIVKA-II, a biomarker for early diagnosis of hepatocellular carcinoma (HCC)

Author:  Dr Phuong-Nhi BORIES - Praticien Hospitalier - Service de Biochimie - Pr Luc CYNOBER - HUPC - Hôpital Cochin - France

The Clinical Chemistry Department of the Hôpital Cochin, part of «Hôpitaux Universitaires Paris Centre» (HUPC) is equipped with an automated platform for routine assays including general biochemistry parameters and common tumor markers as well as dedicated analyzers for more specialized research in areas such as nutrition, diabetes, geriatric medicine (Alzheimer’s disease) and neuroendocrine tumor markers.

Oncology is one of the main specializations of the hospital. The Hepatology Unit at the Hôpital Cochin is closely involved in the follow-up of patients with viral or alcoholic hepatitis who are at risk of developing hepatocellular carcinoma (HCC) and makes extensive use of alphafoetoprotein (AFP) assays to diagnose this pathology.

In this context, Fujirebio France has introduced the laboratory to the measurement of PIVKA-II (Protein Induced by Vitamin K Absence or Antagonist II), an inactive precursor of prothrombin. This marker, already well known and prescribed in East Asia, is proposed as an addition to the AFP test and medical imaging for the preclinical diagnosis of HCC.

The Clinical Chemistry Department undertook a retrospective study in a cohort of 173 patients. HCC was diagnosed by criteria of imaging and/or histology. PIVKA-II and AFP were tested by chemiluminescent assays on LUMIPULSE® G600II (Fujirebio) and on Cobas e602 (Roche Diagnostics) analyzers respectively in serum samples taken close to the time of diagnosis of HCC in 57 patients or during follow-up of 116 patients with viral hepatitis or compensated cirrhosis. The study demonstrated a better performance of PIVKA-II compared to AFP for HCC diagnosis.

This new biomarker is now available to clinicians in the HUPC for routine tests. Its use is recommended in cases of suspected HCC where there is a discrepancy between imaging and AFP results.

Dr Phuong-Nhi BORIES
Praticien Hospitalier
Service de Biochimie - Pr Luc CYNOBER
HUPC- Hôpital Cochin
27 Rue du Faubourg Saint-Jacques
75014 Paris

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