Protein Induced by Vitamin K Absence or Antagonist-II: Significantly Elevated in Obstructive Jaundice and Sepsis Patients Without Hepatocellular Carcinoma.

BACKGROUND: PIVKA-II is a promising diagnostic and prognostic biomarker for HCC. However, a particular PIVKA-II variant can be abnormally elevated in patients with obstructive jaundice or sepsis, complicating its interpretation in HCC conditions. METHODS: This study aimed to investigate the distribution and positive rates of serum PIVKA-II and AFP in patients with obstructive jaundice or sepsis, and to explore their relationships with laboratory tests, particularly coagulation function indexes. The receiver operating characteristic (ROC) curve was used to determine the cut-off, specificity and sensitivity of PIVKA-II in diagnosing HCC. RESULTS: In patients with obstructive jaundice and sepsis, PIVKA-II was significantly positively correlated with PT and INR. When the cut-off was 42.17 mAU/mL, the sensitivity and specificity of PIVKA-II in diagnosing HCC were 74.69% and 70.17%, respectively. There was no difference in PIVKA-II concentration between HCC and obstructive jaundice. PIVKA-II levels in obstructive jaundice and sepsis were significantly higher than those in healthy controls. Except for healthy individuals, the positive rate of serum PIVKA-II was significantly higher than that of AFP among the other three groups, and patients with obstructive jaundice had the highest positive rate of PIVKA-II. CONCLUSIONS: The PIVKA-II produced by HCC may differ from that produced by obstructive jaundice and sepsis. Given that PIVKA-II levels are abnormally elevated in patients with obstructive jaundice and sepsis, the results should be interpreted with caution in patients with HCC combined with these diseases.