Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region
2
Issued Date
2023-04-01
Resource Type
ISSN
22872728
eISSN
2287285X
Scopus ID
2-s2.0-85152733732
Pubmed ID
36710606
Journal Title
Clinical and Molecular Hepatology
Volume
29
Issue
2
Start Page
277
End Page
292
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical and Molecular Hepatology Vol.29 No.2 (2023) , 277-292
Suggested Citation
Kim D.Y., Toan B.N., Tan C.K., Hasan I., Setiawan L., Yu M.L., Izumi N., Huyen N.N., Chow P.K.H., Mohamed R., Chan S.L., Tanwandee T., Lee T.Y., Hai T.T.N., Yang T., Lee W.C., Chan H.L.Y. Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region. Clinical and Molecular Hepatology Vol.29 No.2 (2023) , 277-292. 292. doi:10.3350/cmh.2022.0212 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/81607
Title
Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region
Author's Affiliation
Japanese Red Cross Musashino Hospital
Siriraj Hospital
Rumah Sakit Kanker Dharmais
Duke-NUS Medical School
Kaohsiung Medical University Chung-Ho Memorial Hospital
Hanoi Medical University
Universitas Indonesia
Asan Medical Center
National Cancer Centre, Singapore
Chung Shan Medical University
Second Military Medical University
Singapore General Hospital
Yonsei University College of Medicine
University of Malaya Medical Centre
National Sun Yat-Sen University
Veterans General Hospital-Taichung Taiwan
Chinese University of Hong Kong
National Hospital for Tropical Diseases
University Medical Center
Siriraj Hospital
Rumah Sakit Kanker Dharmais
Duke-NUS Medical School
Kaohsiung Medical University Chung-Ho Memorial Hospital
Hanoi Medical University
Universitas Indonesia
Asan Medical Center
National Cancer Centre, Singapore
Chung Shan Medical University
Second Military Medical University
Singapore General Hospital
Yonsei University College of Medicine
University of Malaya Medical Centre
National Sun Yat-Sen University
Veterans General Hospital-Taichung Taiwan
Chinese University of Hong Kong
National Hospital for Tropical Diseases
University Medical Center
Other Contributor(s)
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.