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Despite moderate sensitivity, alpha fetoprotein (AFP) is widely used in screening and prognostication for hepatocellular carcinoma (HCC). The objective of the current study was to assess clinical utility of Prothrombin induced by Vitamin K absence-II (PIVKA-II) in addition to AFP in patients with HCC.

244 patients with documented AFP, PIVKA-II and dynamic imaging of the liver were reviewed retrospectively. Using ROC curves, cutoff values for AFP and PIVKA-II for HCC detection, tumor grade and microvascular invasion (MVI) were assessed. In patients who underwent liver transplantation (LT) for HCC, survival was determined using Kaplan Meier curves.