My name is Bao Toan Nguyen, Lab Manager at MEDIC Center in Ho Chi Minh City, Vietnam. I have worked at MEDIC since 1999. I have been focusing on immunoassay, infectious disease, cancer, lab automation system, and lab quality. Lately, I am very interested in research that investigates biomarkers in early detection of HCC.
Tell us about MEDIC-LAB
MEDIC was established in 1990 in Ho Chi Minh City and is the first private and largest laboratory in South Vietnam. In 2007 we acquired ISO 9000 and in 2017 we acquired ISO 15189.
Why was PIVKA-II implemented in your lab? What was the clinician’s unmet need?
HCC is the most common cancer among all cancers in Vietnam. Unfortunately, about 65% newly diagnosed HCC cases are diagnosed at the advanced stage. Currently Vietnamese doctors are familiar with AFP and ultrasound for HCC surveillance, but AFP and ultrasound have limitations in HCC early detection. Therefore, more biomarkers are designed to increase the early detection rates. The new biomarker, PIVKA-II, has been introduced in Vietnam since 2015.
What’s your experience with PIVKA-II?
Using a combination of PIVKA II and AFP, overall sensitivity for HCC detection was 92% at the specificity of 82%. At MEDIC our clinical doctors combine PIVKA-II and AFP for HCC diagnosis and surveillance.
Clinical case 1:
Patient is a male, 44 years old. His HBV infection was more than ten years ago, no treatment. AFP is normal: 2.64 ng/mL, but PIVKA-II is so high: 217 ng/mL, and CT scan shows a 5 cm liver tumor.
Clinical case 2:
Patient is also a male, 56 years old, post-hepatectomy. From ultrasound conclusion, the patient has an HCC tumor. AFP is very low: 1.36 ng/mL, but PIVKA-II is very high: more than 23,000 ng/mL.
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