Wei, Lai Thing
(2023)
The Assessment of Interleukin-6, Protein Induced by Vitamin K Antagonist II, and Alpha-Fetoprotein Among Hepatocellular Carcinoma Patients in Hospital Universiti Sains Malaysia.
PhD thesis, Universiti Sains Malaysia.
Abstract
Hepatocellular carcinoma (HCC) is a primary liver cancer that has a poor
prognosis and a high prevalence among the Malaysians. At present, ultrasonography
and serum Alpha-fetoprotein (AFP) are the only tools for HCC screening in this
country. Serum Interleukin-6 (IL-6) and Protein Induced by Vitamin K Absence or
Antagonist-II (PIVKA-II) are two potential serum biomarkers that were shown to be and AFP (Sn 73.08%, Sp 97.06%). Furthermore, the combination of all three serum
biomarkers demonstrated the best diagnostic performance in HCC diagnosis
(AUC=0.999). Conclusively, serum IL-6 and PIVKA-II have potential uses in HCC
diagnosis as well as HCC treatment monitoring, especially when used in combination
with serum AFP.
elevated in HCC patients. However, there had been insufficient research on them in
our population. This study aimed to assess the serum IL-6 and PIVKA-II levels among
HCC subjects in Hospital USM , before and after treatment, as well compare their
levels to those of serum AFP. Twenty six HCC subjects (Group 1) and thirty four
healthy subjects (Group 2) were recruited. For Group 1, blood samples were collected
and radiological assessments of their HCC lesions were done at the first visit and 6-
weeks after their local treatment. For Group 2, only blood samples were only collected
once. This study found that serum IL-6, PIVKA-II and AFP had higher median levels
in HCC subjects than healthy subjects (p<0.001). IL-6 was not significantly correlated
with radiological response post treatment (p=0.822). When comparing pre- and posttreatment
values, serum IL-6 levels did not change significantly (p=0.328), whereas
serum PIVKA-II levels were most significantly different (p<0.001) followed by serum
AFP levels (p=0.007). In HCC diagnosis, PIVKA-II had the higher sensitivity and
specificity (Sn 92.30%, Sp 94.11%) followed by serum IL-6 (Sn 84.62%, Sp 70.59%)
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