Please use this identifier to cite or link to this item: https://doi.org/10.3350/cmh.2022.0212
Title: Utility of combining PIVKA-II and AFP in the sur- veillance and monitoring of hepatocellular carci- noma in the Asia-Pacific region
Authors: Kim, Do Young
Toan, Bao Nguyen
Tan, Chee-Kiat 
Hasan, Irsan
Setiawan, Lyana
Yu, Ming-Lung
Izumi, Namiki
Huyen, Nguyen Nguyen
Chow, Pierce Kah-Hoe 
Mohamed, Rosmawati
Chan, Stephen Lam
Tanwandee, Tawesak
Lee, Teng-Yu
Hai, Thi Thanh Nguyen
Yang, Tian
Lee, Woo-Chang
Chan, Henry Lik Yuen
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
PIVKA-II
Alpha-fetoprotein
Carcinoma
hepatocellular
Consensus
Biomarkers
GAMMA-CARBOXY PROTHROMBIN
ALPHA-FETOPROTEIN
TUMOR-MARKER
MICROVASCULAR INVASION
BIOMARKER DEVELOPMENT
LIVER-DISEASE
RECURRENCE
CARBOXYPROTHROMBIN
PERFORMANCE
PREDICTION
Issue Date: Apr-2023
Publisher: KOREAN ASSOC STUDY LIVER
Citation: Kim, Do Young, Toan, Bao Nguyen, Tan, Chee-Kiat, Hasan, Irsan, Setiawan, Lyana, Yu, Ming-Lung, Izumi, Namiki, Huyen, Nguyen Nguyen, Chow, Pierce Kah-Hoe, Mohamed, Rosmawati, Chan, Stephen Lam, Tanwandee, Tawesak, Lee, Teng-Yu, Hai, Thi Thanh Nguyen, Yang, Tian, Lee, Woo-Chang, Chan, Henry Lik Yuen (2023-04). Utility of combining PIVKA-II and AFP in the sur- veillance and monitoring of hepatocellular carci- noma in the Asia-Pacific region. CLINICAL AND MOLECULAR HEPATOLOGY 29 (2) : 277-292. ScholarBank@NUS Repository. https://doi.org/10.3350/cmh.2022.0212
Abstract: Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
Source Title: CLINICAL AND MOLECULAR HEPATOLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/241705
ISSN: 2287-2728
2287-285X
DOI: 10.3350/cmh.2022.0212
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