Protein Induced By Vitamin K Absence Ⅱ Is A Potential Biomarker In Diagnosis And Vascular Invasion Of Pancreatic Cancer

Background:PIVKA-Ⅱ(Prothrombin induced by vitamin K absence-Ⅱ)is abnormally expressed in various malignant tumors.In recent years,it has been found that PIVKA-Ⅱ is expressed in pancreatic cancer tissues and is involved in the progression of pancreatic cancer.However,the clinical value remains unclear.We assessed the ability of PIVKA-Ⅱ in diagnosis and predicting vascular invasion in pancreatic cancer.Material and methods:This retrospective study was conducted in 239 patients with pancreatic lesions:149 pancreatic cancer and 90 pancreatic benign lesions controls from 2017 to 2020.The content of serum PIVKA-Ⅱ was measured by chemiluminescence enzyme immunoassay.All diagnoses were confirmed histopathologically.Receiver operating characteristics(ROC)curves were established to determine the optimal cut-off value.Results:There was a significant difference in levels of serum PIVKA-Ⅱ between PC patients and patients with pancreatic benign lesions(p<0.001).When the cut-off value was set to 28.895mAU/ml according to the ROCs,the sensitivity and specificity of PIVKA-Ⅱ were 65.8%and 83.3%respectively.The combined PIVKA-Ⅱ and carbohydrate antigen 19-9(CA19-9)enhanced the diagnostic accuracy.The AUC,sensitivity,and specificity were 0.935,83.9%,and 95.6%respectively..Then we validated the conclusion in patients with non-jaundice,the sensitivity and specificity were 63.64%and 79.13%,respectively(p<0.001).Elevated PIVKA-Ⅱ also had diagnostic value in the CA 19-9-negative cohort with sensitivity of 60.71%and specificity of 86.21%.PIVKA-Ⅱ>36.38mAU/ml was an independent predictive factor of vascular invasion in PC(p<0.001).Conclusion:PIVKA-Ⅱ was a potential diagnostic biomarker in PC.The combined PIVKA-Ⅱand CA19-9 enhanced the detection accuracy in PC.PIVKA-Ⅱ>36.38mAU/ml was an independent predictive factor of vascular invasion in PC.