{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:38:42Z","timestamp":1788903522388,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Scientific Research Fund Project of Gansu Provincial Hospital","award":["17GSSY1-6"],"award-info":[{"award-number":["17GSSY1-6"]}]},{"name":"Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province","award":["2019GSZDSYS01"],"award-info":[{"award-number":["2019GSZDSYS01"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early diagnosis decreases the mortality of hepatocellular carcinoma (HCC). We aimed to investigate the usefulness of PIVKA\u2010II, AFP, AFP\u2010L3, CEA, and their combinations in the diagnosis of primary and metastatic HCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred and twenty patients with primary HCC (PHC), 115 with metastatic HCC (MHC), 89 with chronic liver disease (CLD), and 116 healthy volunteers were included. The diagnostic values of each marker and their combinations for HCC diagnosis were represented by ROC curve analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PIVKA\u2010II, AFP, and AFP\u2010L3 levels in PHC group were higher than that in normal control, CLD, and MHC groups. CEA levels in MHC group were higher than that in the other three groups. When the four markers were analyzed individually, PIVKA\u2010II showed the highest positive rate in PHC group (76.7%) and CEA showed the highest positive rate in MHC group (69.6%). PIVKA\u2010 II showed the largest area under ROC curve (AUC\u00a0=\u00a00.835) to discriminate PHC group from CLD group. Combined PIVKA\u2010II with AFP\u2010L3 increased the AUC to 0.910. CEA showed the highest AUC (0.849) to discriminate MHC group from CLD group. Combined CEA with PIVKA\u2010II increased the AUC to 0.866. AFP\u2010L3 alone showed the highest AUC (0.890) to discriminate MHC group from PHC group. Combined PIVKA\u2010II with AFP\u2010L3, and CEA increased the AUC to 0.957.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PIVKA\u2010II, AFP\u2010L3, AFP, and CEA are effective biomarkers for the diagnosis of PHC and MHC. Their combinations could improve the diagnostic performance compared with each marker used alone in detecting PHC and MHC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.23158","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T08:40:57Z","timestamp":1575967257000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["The diagnostic value of PIVKA\u2010II, AFP, AFP\u2010L3, CEA, and their combinations in primary and metastatic hepatocellular carcinoma"],"prefix":"10.1002","volume":"34","author":[{"given":"Famei","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Gansu Provincial Hospital Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aihua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Gansu Provincial Hospital Lanzhou 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