Validity of Prothrombin-induced Vitamin K antagonist versus Alpha-Fetoprotein (Tumor Markers) in Diagnosis of Hepatocellular Carcinoma, Using Computed Tomography scan as Gold Standard: Validity of prothrombin-induced Vitamin K antagonist versus Alpha-Fetoprotein in Hepatocellular Carcinoma Diagnosis

Amer Latif; Riffat Saeed; Tariq Ali Banghash; Muhammad Khawar Shahzad; Hassam Ahmed; Muhammad Asif Naveed; Usama Amer

doi:10.54393/pjhs.v5i07.1804

Authors

Amer Latif Department of Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore, Pakistan
Riffat Saeed Department of Anesthesiology, Shaikh Zayed Hospital, Lahore, Pakistan
Tariq Ali Banghash Department of Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore, Pakistan
Muhammad Khawar Shahzad Department of Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore, Pakistan
Hassam Ahmed Department of Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore, Pakistan
Muhammad Asif Naveed Department of Hepatobiliary Unit, Shaikh Zayed Hospital, Lahore, Pakistan
Usama Amer Department of Anesthesiology, Army Medical College Combined Military Hospitals, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i07.1804

Keywords:

Alpha Fetoproteins, Hepatocellular Carcinoma, Tumor Markers

Abstract

Biomarkers like alpha-fetoprotein and prothrombin-induced Vitamin K deficiency/ antagonist are used in the early diagnosis and staging of hepatocellular carcinoma and are useful for better outcomes in the treatment and overall survival of the patient. Objective: To compare the diagnostic accuracy of alpha-fetoprotein and prothrombin-induced Vitamin K antagonist in the diagnosis of hepatocellular carcinoma using a computed tomography scan as a gold standard. Methods: A cross-sectional study was conducted in the Liver Transplant Unit of Shaikh Zayed Postgraduate Medical Complex, Lahore from July 2023 to January 2024. A total of 94 patients older than 12 years old with cirrhosis and CT scan suggestive of hepatocellular carcinoma were selected. Blood was collected to test for AFP and PIVKA-II. The samples were sent to the labs after labeling them properly and the results were collected and entered in the data sheet. Patients were advised to have a multiphase contrast-enhanced CT scan. Patients were followed up in the clinic after 7 days. Results: The diagnostic accuracy of AFP was 78% with a 74.7% sensitivity, 100% specificity, 100% positive predictive value, and 41.67% negative predictive value. The diagnostic accuracy of PIKVA-II was found to be 87.76% with 89% sensitivity, 80% specificity, 96.1% PPV, and 57.14% NPV. Conclusions: On comparing the tumor markers AFP with PIVKA-II against the gold standard multiphase CT scan it was found that PIVKA-II has better diagnostic accuracy than AFP.

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