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Sains Malaysiana 50(2)(2021): 475-480
http://dx.doi.org/10.17576/jsm-2021-5002-18
(Perkaitan antara Protrombin yang Dipengaruhi oleh Ketiadaan Vitamin K II (PIVKA-II)
DARMADI DARMADI1*
& RISKA HABRIEL RUSLIE2
1Department of Internal Medicine, Faculty
of Medicine, Universitas Sumatera Utara, dr. Mansyur 5, Medan, Indonesia
2Faculty of Medicine, Universitas Prima Indonesia, Ayahanda 68 A, Medan, Indonesia
Diserahkan: 5 April 2020/Diterima:
5 Ogos 2020
ABSTRACT
Hepatocellular carcinoma is one of the
major cancer problems in the world because of the low early screening awareness
in patients. Serum alpha-fetoprotein is not adequate as a single screening
tool, especially for small HCCs, thus, prothrombin induced by vitamin K
absence-II (PIVKA-II) can help in detecting small HCCs. Barcelona Clinic Liver
Cancer (BCLC) stage remains to be the preferred HCC classification because it
can predict the outcome and help in choosing available treatment options
according to stages. This study aims to investigate the association between
PIVKA-II levels with BCLC stage, tumor size, portal venous thrombosis in HCC
patients. We enrolled patients with newly diagnosed HCC at the Adam Malik
General Hospital, Medan, Indonesia from January to December 2018. Patients with
HCC were classified according to BCLC stages, findings of portal venous
thrombosis and tumor size from triphasic CT scan were noted, and serum PIVKA-II
levels were measured. Sixty patients were included in this study. There were
significant differences in serum PIVKA-II levels with different stages of BCLC
(p < 0.001). Significantly higher serum PIVKA-II levels were detected in
patients with portal venous thrombosis (p < 0.001) and larger size tumors (p
< 0.003). Our study shows that serum PIVKA-II levels can help to diagnose,
differentiate between stages of BCLC, and determine the prognosis in patients
with HCC.
Keywords: Hepatocellular carcinoma;
hepatoma; liver cell carcinoma; tumor biomarkers
ABSTRAK
Karsinoma hepatosel adalah salah satu masalah kanser utama di dunia kerana kesedaran awal yang rendah dalam kalangan pesakit. Serum alfa-fetoprotein tidak mencukupi sebagai alat pemeriksaan tunggal, terutamanya untuk HCCs kecil, oleh itu protrombin yang disebabkan oleh ketiadaan vitamin
K II (PIVKA-II) dapat membantu dalam mengesan HCCs kecil. Tahap Kanser Hati Klinik Barcelona
(BCLC) tetap menjadi pilihan dalam pengelasan HCC kerana dapat meramalkan hasil dan membantu dalam memilih pilihan rawatan yang tersedia mengikut tahap. Kajian ini bertujuan untuk mengkaji hubungan antara tahap PIVKA-II dengan peringkat BCLC, saiz tumor, trombosis vena portal
pada pesakit HCC. Kami mendaftarkan pesakit dengan HCC yang baru didiagnosis di Hospital Besar Adam Malik, Medan, Indonesia sepanjang tempoh Januari hingga Disember 2018. Pesakit dengan HCC dikelaskan mengikut tahap BCLC, penemuan trombosis vena portal dan saiz tumor daripada imbasan CT
triphasic dicatat dan paras serum PIVKA-II dihitung. Enam puluh pesakit dimasukkan ke dalam kajian ini. Terdapat perbezaan yang signifikan antara paras serum PIVKA-II dengan peringkat BCLC yang berlainan (p
< 0.001). Tahap serum PIVKA-II yang lebih tinggi dikesan pada pesakit dengan trombosis vena portal (p < 0.001) dan tumor saiz yang lebih besar (p < 0.003). Kajian kami menunjukkan bahawa tahap serum PIVKA-II boleh membantu untuk mendiagnosis, membezakan antara peringkat BCLC dan menentukan prognosis pada pesakit dengan HCC.
Kata kunci: Penanda biologi tumor; hepatoma; karsinoma hepatosel; karsinoma sel hati
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*Pengarang untuk surat-menyurat; email: ign.darmadi@yahoo.com
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