{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:59:30Z","timestamp":1766069970809,"version":"3.48.0"},"reference-count":30,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PIVKA\u2010II is a promising diagnostic and prognostic biomarker for HCC. However, a particular PIVKA\u2010II variant can be abnormally elevated in patients with obstructive jaundice or sepsis, complicating its interpretation in HCC conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study aimed to investigate the distribution and positive rates of serum PIVKA\u2010II and AFP in patients with obstructive jaundice or sepsis, and to explore their relationships with laboratory tests, particularly coagulation function indexes. The receiver operating characteristic (ROC) curve was used to determine the cut\u2010off, specificity and sensitivity of PIVKA\u2010II in diagnosing HCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In patients with obstructive jaundice and sepsis, PIVKA\u2010II was significantly positively correlated with PT and INR. When the cut\u2010off was 42.17\u2009mAU\/mL, the sensitivity and specificity of PIVKA\u2010II in diagnosing HCC were 74.69% and 70.17%, respectively. There was no difference in PIVKA\u2010II concentration between HCC and obstructive jaundice. PIVKA\u2010II levels in obstructive jaundice and sepsis were significantly higher than those in healthy controls. Except for healthy individuals, the positive rate of serum PIVKA\u2010II was significantly higher than that of AFP among the other three groups, and patients with obstructive jaundice had the highest positive rate of PIVKA\u2010II.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PIVKA\u2010II produced by HCC may differ from that produced by obstructive jaundice and sepsis. Given that PIVKA\u2010II levels are abnormally elevated in patients with obstructive jaundice and sepsis, the results should be interpreted with caution in patients with HCC combined with these diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70128","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T11:49:44Z","timestamp":1763034584000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protein Induced by Vitamin K Absence or Antagonist\u2010\n                    <scp>II<\/scp>\n                    : Significantly Elevated in Obstructive Jaundice and Sepsis Patients Without Hepatocellular Carcinoma"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7550-2931","authenticated-orcid":false,"given":"Ke","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiarui","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianran","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30010-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.11.005"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.12.001"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04014.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0212"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2011.00521.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000327577"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-2195-0"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2513-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000537897"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32185"},{"issue":"7","key":"e_1_2_11_13_1","article-title":"A Case of Significant Coagulopathy due to Vitamin K Deficiency Caused by the Administration of Cefazolin and Rifampicin and Hyponutrition After a Postoperative Infection of the Lumbar Spine","volume":"16","author":"Tatsumura M.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14223"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-44255-2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2019.020707"},{"issue":"36","key":"e_1_2_11_17_1","first-page":"1695","article-title":"PIVKA\u2010II During Perioperative Period in Patients With Hepato\u2010Biliary\u2010Pancreatic Diseases","volume":"47","author":"Kanazumi N.","year":"2000","journal-title":"Hepato\u2010Gastroenterology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003448"},{"issue":"11","key":"e_1_2_11_19_1","first-page":"2059","article-title":"Plasma Vitamin K1 Level Is Decreased in Primary Biliary Cirrhosis","volume":"92","author":"Kowdley K. 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