PIVKA-II (protein induced by vitamin K deficiency or antagonist II) is a potential hepatocellular carcinoma (HCC) specific marker, however it can also be produced by a small number of stomach cancers. So far, 16 cases of PIVKA-II-producing stomach cancer have been reported, two of which were reported by us and all of which were discovered in Japan. Serum alpha-fetoprotein (AFP) levels are almost always high as well. In around 80% of cases, liver metastases is discovered, and portal vein tumour thrombus is discovered in about 20% of cases. It's not always easy to distinguish between a metastatic liver tumour and HCC. On the surface, almost all of the patients appear to be advanced stomach cancer. A hepatoid pattern, as well as a moderately to poorly differentiated adenocarcinoma component, is seen in many instances. To validate the formation of PIVKA-II and AFP, immunohistochemical staining is usually utilised. Treatment and prognosis are influenced by the existence of liver metastasis, and patients with liver metastasis have a poor prognosis. During hepatocellular metaplasia, tumour cells may produce PIVKA-II.
Author (s) Details
Yoshihisa Takahashi
Department of Pathology, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
Tohru Inoue
Department of Pathology, Tokyo Kousei-Nenkin Hospital, Tokyo 162-8543, Japan.
Toshio Fukusato
Department of Pathology, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
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