The Clinical Significance of PIVKA-II Determination in Patients with Hepatic, Biliary and Pancreatic Diseases

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 23; no. 4; pp. 1016 - 1021
• Main Authors: Endoh, Wakio, Monden, Morito, Gotoh, Mitsukazu, Mori, Takesada, Kanai, Toshio, Sakon, Masato, Umeshita, Kouji
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1990
• Subjects: hepatocellular carcinoma; PIVKA-II; vitamin K
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.23.1016

To investigate the mechanisms involved in the generation of PIVKA-II (protein induced by vitamin K absenceor antagonist-II) in HCC (hepatocellular carcinoma), the amount of vitamin K (K1, MK4, MK7) or PIVKA-II inplasma was measured. The plasma level of vitamin K was not decreased in patients with HCC compared with thatin normal subjects; it was increased in patients with liver cirrhosis (VK1, MK4, VK1 + MK4 + MK7). The plasma evel or positivity rate of PIVKA-II was decreased by the administration of vitamin K. This indicates that themetabolism or availability of vitamin K might be impaired in HCC. In patients with biliary or pancreatic disease, allcases with positive PIVKA-II underwent PTBD (percutaneous transhepatic biliary drainage), indicating that notonly vitamin K deficiency but also its impaired metabolism due to obstructive jaundice might account for thesynthesis of PIVKA-II. Since the impairment of vitamin K metabolism is considered to be one of the characteristicsof HCC, PIVKA-II must be measured without vitamin K administration and if administrated, it should be carefullyevaluated considering the effects of vitamin K on PIVKA-II.