Abstract: Objective To evaluate the diagnostic value of serum prothrombin induced by vitamin K absence or antagonist-II(PIVKA-II)in patients with liver metastasis of colorectal cancer(CRC). Methods A total of 120 CRC patients(including 80 without organ metastasis and 40 with liver metastasis), 80 patients with early-stage hepatocellular carcinoma(HCC)and 80 healthy controls were involved in the study. The levels of serum PIVKA-II and carcinoembryonic antigen(CEA)were determined to evaluate the optimal cut-off values. The diagnostic sensitivity and specificity of PIVKA-II and CEA for the liver metastasis of CRC were analyzed. Results The median concentrations of serum PIVKA-II in healthy controls, CRC patients without organ metastasis, CRC patients with liver metastasis and early-stage HCC patients were 18(15-20.8)mAU/mL, 20(17-24)mAU/mL, 32(22.3-41.8)mAU/mL and 345(31.8-3 787)mAU/mL, respectively. The median PIVKA-II level was significantly greater in CRC patients with liver metastasis 山 东 大 学 学 报 (医 学 版)56卷10期 -朱宇,等.人异常凝血酶原(PIVKA-II)在监测结直肠癌肝转移中的应用 \=-than that in healthy controls (P<0.001)and CRC patients without organ metastasis(P<0.001), but significantly lower than that in early-stage HCC patients(P<0.001). There was no significant difference between PIVKA-II and CEA in the area under the receiver operating characteristic curve(AUC)［0.818(95%CI: 0.736-0.901)vs 0.799(95%CI: 0.710-0.888), Z=0.332, P=0.74］. The optimal cut-off value of PIVKA-II for the detection of CRC liver metastasis was 28.5 mAU/mL, with sensitivity of 60% and specificity of 90%. A combination of PIVKA-II and CEA increased the sensitivity(85%)in detecting CRC liver metastasis. Conclusion PIVKA-II could serve as a marker for CRC liver metastasis screening.

Key words: Prothrombin induced by vitamin k absence or antagonist-II, Carcinoembryonic antigen, Colorectal cancer, Liver metastasis, Diagnosis