Page 238 - ebook HCC

EASL HCC SUMMITHCC SUMMIT
GENEV
PROGRAMME AND ABSTRACTSAND ABSTRACTS
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236 PROGRAMME GENEVA, SWITZERLANDA, SWITZERLAND EASL 237
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C26 Poster Board Number C27
PIVKA-II : A TISSUE BIOMARKER IS FIB-4 INDEX USEFULL FOR PREDICTING
OF MICROVASCULAR INVASION IN OCCURENCE OF HEPATOCELLULAR
HEPATOCELLULAR CARCINOMAS CARCINOMA IN PATIENTS WITH HEPATITIS
C VIRUS HAS GOT NORMAL ALANINE
Nicolas Poté , Miguel Albuquerque , Mohamed Achahboun , Laurent Castera , AMINOTRANSFERASE LEVELS
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Jacques Belghiti , Pierre Bedossa , Valérie Paradis 1
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1 Pathology, Hepatology, Liver Surgery, Beaujon Hospital, Clichy, France
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Goktug Sirin , Omer Sentürk , Altay Celebi , Sadettin Hülagu 1
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Corresponding author’s e-mail: vparadis@teaser.fr 1 Gastroenterology, Kocaeli University, Kocaeli, Turkey
Corresponding author’s e-mail: gsirin@live.com
Introduction: Microvascular invasion (mVI) is a main prognostic factor of hepatocellular
carcinoma (HCC). mVI tissue biomarkers have been identified without any further
validation. We previously reported that PIVKA-II (Protein Induced by Vitamin K absence or Introduction: The FIB-4 index is a simple formula to predict liver fibrosis based on
Antagonist-II) serum level was correlated with mVI in patients with HCC associated with standard biochemical values, using age, aspartate aminotransferase(AST), alanine
chronic liver diseases (Paradis V et al EASL 2013). aminotransferase (ALT), and platelet count.
Aims: The aim of the study was to assess the prognostic value of PIVKA expression in a Aims: We investigated the use of the FIB-4 index in predicting the incidence of hepatocellular
western series of HCC tumor samples. carcinoma (HCC) in patients with hepatitis C virus has got normal ALT levels.
Methodology: A set of 84 HCC dpecimens obtained from liver resection or transplantation Methodology: A total of 114 patients with ALT levels persistently less than or equal to
were studied. Immunohistochemistry was performed using anti-PIVKA-II antibody (EIDIA, 35 IU/L during the observation period over 2 years were included. None of the patients
dilution 1/200). Immunostaining scoring system was based on a 3-grade scale (0: < 10% received antiviral therapy. Factors associated with the cumulative incidence of HCC were
positive tumoral cells, 1: 10% ≤ positive tumoral cells < 50% and 2: ≥ 50% positive tumoral determined.
cells).
Results: HCC developed in 11 of 114 patients (9.65%). The rates of HCC at 3 and 5 years
CLINICAL POSTER ABSTRACTS serum level median value was 101 AU (ranges 4-75,000). PIVKA immunostaining was HCC at 5 years were 0.1%, 0.6%, and 4.6%, and those at 8 years were 4%, 20.1%, and CLINICAL POSTER ABSTRACTS
Results: HCC mean size was 3.1±2.2 cm. Tumor was well and moderately to poorly-
were 0.6% and 2.4%, respectively. When patients were categorized based on the FIB-4
index: ≤2.0 (n=66), >2.0 and ≤4.0 (n=32), and >4.0 (n=16), the cumulative incidences of
differentiated in 40% and 60%, respectively. mVI was present in 52% of cases. PIVKA-II
33.3%, respectively. The patients with FIB-4 index > 4.0 was at a highest risk for HCC
scored 0, 1 and 2 in 39, 17 and 28 HCC, respectively. PIVKA tumor expression was
development (p<0.001). Factors that were significantly associated with the incidence of
correlated with mVI (p=0.05). No correlation was observed with tumor size or differentiation.
PIVKA-II serum level increased with % of positive tumoral cells (p=0,08).
HCC by multivariate analysis were FIB-4 index >2.0 (hazard ratio: 4.70 [95% confidence
α-fetoprotein(AFP) >10 ng/ml (2.352[1.25–4.823] ; p<0.001) and AFP >20 ng/ml (4.211
Conclusions: This study shows the prognostic value of PIVKA-II in tumor samples of
HCC. Its performance in biopsy samples needs to be investigated. interval, 2.124–11.234]; p<0.001) and FIB-4 index >4.0 (5.90 [2.624–16.112] ; p<0.001),
[2.112–8.242] ; p<0.001). There was no significant statistically correlation between FIB-4
index and AFP.
Conclusions: The FIB-4 index is closely associated with the risk of HCC in patients with
hepatitis C virus has got normal ALT levels.