Pivka II test...

[happymom2v]

Pivka II...I don't understand what type of blood test is this? What I am reading, has me confused. Is this a common test used in POST transplant patients to indicate reoccurance of HCC? Is this a reliable test?

What types of tumor marker blood tests are used as a screening tool POST transplant?

Thank you in advance.

[happymom2v]

Thank you very, very much.

[Thomas D Schiano, MD]

if the HCC did not produce AFP prior to the transplant a recurrence would not elevate it.  Pivka ll is definitely not standard of care to follow--I am sorry if I cant give you further specifics about it

[happymom2v]

1. What if the AFP was never elevated PREtransplant? If the HCC reappeared, what is the likelihood that the AFP would be elevated POST transplant?

2. Do only certain transplant centers use the Pivka II? How reliable is this test versus the AFP?

Thank you in advance.

[Thomas D Schiano, MD]

at our center we only use AFP as a serum marker, which is only relevant if the HCC was AFP-producing pre-transplant.  We screen with abdominal imaging and AFP periodically post-transplant.

[hp00]

I saw this test in South Korea and used for time.  This is detecting for liver cell cancer and similar to AFP.  I heard there is no definite conclusion which is better.

[mikesimon]

Impact of PIVKA-II in diagnosis of hepatocellular carcinoma

Abstract

Liver cancer grows silently with mild or no symptoms until advanced. In the absence of an effective treatment for advanced stage of hepatic cancer hope lies in early detection, and screening for high-risk population. Among Egyptians viral hepatitis is the most common risk factor for hepatocellular carcinoma (HCC). The current work was designed to determine the level of prothrombin induced by vitamin K absence-II (PIVKA-II) in sera of patients suffering from HCC and hepatitis C virus (HCV) patients being the most common predisposing factor for HCC. Our ultimate goal is diagnosis of HCC at its early stage. The current study was carried out on 83 individuals within three groups; Normal control, HCV and HCC groups. Patients were subdivided into cirrhotic and non-cirrhotic. Complete clinicopathological examination was carried out for each individual to confirm diagnosis. Individuals’ sera were subjected to quantitative determination of alpha-fetoprotein (AFP), PIVKA-II and other parameters. PIVKA-II proved to be superior to AFP for early detection of HCC patients being highly sensitive and specific. Furthermore it has the ability to discriminate between different histopathological grades of HCC and It has a powerful diagnostic validity to evaluate the thrombosis of portal vein and to differentiate between early and late stages of HCC. The direct relation between the level of PIVKA-II and the size of tumor makes it an attractive tool for early HCC diagnosis and surveillance. Using the best cut-off value of AFP (>28), showed a sensitivity of (44%) and specificity of (73.3%). While cut-off value of PIVKA-II (>53.7) showed 100% sensitivity and specificity.

See the entire article at:

http://www.sciencedirect.com/science/article/pii/S2090123212000999

[happymom2v]

Is the Pivka II test the same/similar test to the "des-gamma-carboxyprothrombin (DCP)"? I read online that this blood test, used in conjunction with AFP, could be very helpful in diagnosing more cases of HCC than with AFP alone.

Do only certain transplant centers use the Pivka II?

[happymom2v]

What types of tumor marker blood tests are recommended as a screening tool for HCC, POST transplant? Are these reliable tests? Is an Mri versus a CT scan preferred Post transplant, for screening? How often does a post transplant patient need to be scanned (reason for transplant was HCC due to Cirrohis) after transplant?
Thank you again.

[Thomas D Schiano, MD]

i am not familiar with this blood test--it may be a variant of AFP testing.  This is definitely not standard to check