March 3, 2026Open Access

Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma

Key Points

Aggressive tumor biology correlates strongly with PIVKA-II levels in alpha-fetoprotein-normal hepatocellular carcinoma.
A cut-off value of 1609.5 mAU/mL effectively balances sensitivity and specificity in these cases.
Assessment using serum protein markers revealed a subgroup with ultra-high risk at levels ≥ 4000 mAU/mL.
These findings may enable improved risk stratification for hepatocellular carcinoma, enhancing treatment decisions.

Abstract

In normal AFP HCC, PIVKA-II discriminates aggressive biology. A cut-off of 1609.5 mAU/mL balances sensitivity and specificity; 400 mAU/mL favors sensitivity; ≥ 4000 mAU/mL delineates an ultra-high-risk subgroup. Findings support the incorporation of PIVKA-II into risk stratification.

Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma

Key Points

Abstract

Cite This Study