Protein induced by vitamin K absence or antagonist-II versus alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: A systematic review with meta-analysis

As a promising biomarker of hepatocellular carcinoma (HCC), protein induced by vitamin K absence or antagonist-II (PIVKA-II) has been studied extensively. However, its diagnostic capability varies across HCC studies. This study aimed to compare the performance of PIVKA-II with alpha-fetoprotein (AFP...

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Bibliographic Details
Published in:Hepatobiliary & pancreatic diseases international 2018-12, Vol.17 (6), p.487-495
Main Authors: Xing, Hao, Zheng, Yi-Jie, Han, Jun, Zhang, Han, Li, Zhen-Li, Lau, Wan-Yee, Shen, Feng, Yang, Tian
Format: Article
Language:English
Subjects:
Alpha-fetoprotein
alpha-Fetoproteins - analysis
Biomarkers - blood
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - diagnosis
Hepatocellular carcinoma
Humans
Liver Neoplasms - blood
Liver Neoplasms - diagnosis
Meta-analyses
Protein induced by vitamin K absence or antagonist-II
Protein Precursors - blood
Prothrombin
Publication Bias
ROC Curve
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Summary:As a promising biomarker of hepatocellular carcinoma (HCC), protein induced by vitamin K absence or antagonist-II (PIVKA-II) has been studied extensively. However, its diagnostic capability varies across HCC studies. This study aimed to compare the performance of PIVKA-II with alpha-fetoprotein (AFP) in the diagnosis of HCC. A systematic literature search was conducted to identify the studies from MEDLINE, Embase and Cochrane Library Databases, which were published up to December 20, 2017 to compare the diagnostic capability of PIVKA-II and AFP for HCC. The data were pooled using random effects model. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curve (ROC) was employed to evaluate the diagnostic accuracy of each marker. Thirty-one studies were included. The pooled sensitivity (95% CI) of PIVKA-II and AFP was 0.66 (0.65–0.68) and 0.66 (0.65–0.67), respectively in diagnosis of HCC; and the corresponding pooled specificity (95% CI) was 0.89 (0.88–0.90) and 0.84 (0.83–0.85), respectively. The area under the ROC curve (AUC) of PIVKA-II and AFP was 0.856 (0.817–0.895) and 0.770 (0.728–0.811), respectively. Subgroup analysis showed that PIVKA-II was superior to AFP in terms of the AUC for both small HCC (
ISSN:1499-3872
DOI:10.1016/j.hbpd.2018.09.009