Volume 28, Issue 4 pp. 671-677
Hepatology

Des-gamma-carboxy prothrombin identified by P-11 and P-16 antibodies reflects prognosis for patients with hepatocellular carcinoma

Satoru Takeji

Satoru Takeji

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Masashi Hirooka

Masashi Hirooka

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Yohei Koizumi

Yohei Koizumi

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Yoshio Tokumoto

Yoshio Tokumoto

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Masanori Abe

Masanori Abe

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Yoshio Ikeda

Yoshio Ikeda

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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Seijin Nadano

Seijin Nadano

Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan

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Yoichi Hiasa

Corresponding Author

Yoichi Hiasa

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

Correspondence

Yoichi Hiasa, Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan. Email: [email protected]

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Morikazu Onji

Morikazu Onji

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon

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First published: 06 December 2012
Citations: 10
Declaration of conflict of interest: The authors declare no conflicts of interest.

Abstract

Background and Aims

Serum des-γ-carboxy prothrombin (DCP) is an established tumor marker in patients with hepatocellular carcinoma (HCC), which can be identified by using MU-3 antibody. The MU-3 antibody mainly reacts with the 9–10 glutamic acid residues of DCP (conventional DCP). Since other variants of DCP with fewer glutamic acid residues can be detected using P-11 and P-16 antibodies (code name: NX-PVKA), we examined the clinical characteristics associated with NX-PVKA, and whether NX-PVKA is a useful measure in HCC patients.

Methods

Participants comprised 197 HCC patients admitted to our hospital between 2001 and 2010. NX-PVKA, conventional DCP, alpha-fetoprotein, and L3 fraction of alpha-fetoprotein were measured prior to initiation of HCC treatment.

Results

Of the tumor markers assessed, NX-PVKA was the only significant predictor of prognosis (hazard ratio, 81.32; P < 0.0001). Patients with NX-PVKA level ≥ 100 mAU/mL showed significantly lower survival rates (P < 0.0001). NX-PVKA level was also significantly associated with platelet count, prothrombin time, C-reactive protein, sex, maximum tumor size, number of nodules, and portal venous invasion by HCC. Finally, using NX-PVKA level and other clinical parameters, we established a prognostic model to estimate patient survival time.

Conclusions

NX-PVKA offers the best marker of tumor prognosis among HCC patients, and is strongly associated with tumor factors and hepatic functional reserve. NX-PVKA could be useful for clinical evaluation of tumor severity, as well as the estimated duration of survival among patients with HCC.

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