Advanced Studies on Protein Induced by Vitamin K Absence or Antagonist II-Producing Gastric Cancer

Abstract

Protein induced by vitamin K absence or antagonist II (PIVKA-II) is a possible hepatocellular carcinoma (HCC) specific marker, however it may also be generated by a limited number of stomach malignancies. PIVKA-II-producing stomach cancer has been recorded in 16 instances so far, two of which were reported by us and all of which were found in Japan. In virtually all instances, serum alpha-fetoprotein (AFP) levels are also elevated. In roughly 80% of instances, liver metastasis is found, and portal vein tumor thrombus is detected in roughly 20% of cases. It's often difficult to tell the difference between a metastatic liver tumor and HCC. Almost all cases appear to be advanced stomach cancer macroscopically. In many cases, a hepatoid pattern is present, as well as a moderately to poorly differentiated adenocarcinoma component. Immunohistochemical staining is frequently used to confirm the generation of PIVKA-II and AFP. The presence of liver metastasis influences treatment and prognosis, and individuals with liver metastasis have a poor prognosis. PIVKA-II may be generated by tumor cells during hepatocellular metaplasia.