Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma

Table 1 Patient demographics and characteristics, n (%)

Variables	Values
Age (years), median (IQR)	58 (52-66)
Gender (male/female)
Male	78 (69)
Female	5 (31)
Etiology
HC	49 (43.4)
HB	27 (23.9)
HB + HD	3 (2.6)
HC + HB	2 (1.7)
MASLD	6 (14.1)
Alcohol	6 (5.3)
Autoimmune liver disease	6 (5.3)
Cryptogenic	4 (3.5)
Lab parameters, median (IQR)
Hemoglobin (g/dL)	11.0 (9.3-13.0)
White cell count (× 109/L)	6.8 (5.0-9.0)
Platelets (× 109/L)	116.5 (84-168)
Total bilirubin (mg/dL)	1.3 (0.7-2.3)
Alanine aminotransferase (IU/L)	47.0 (30.0-73.0)
Aspartate aminotransferase (IU/L)	58 (37.5-87.5)
Alkaline phosphatase (IU/L)	96.5 (140.5-219.0)
International normalized ratio	1.27 (1.10-1.44)
Albumin (g/dL)	2.76 (3.10-3.61)
Creatinine (mg/dL)	0.89 (0.70-1.20)
PIVKA-II (mAU/mL)	492.8 (106.6-4284.8)
Alpha-fetoprotein (ng/mL)	6.0 (3.6-10.0)
Elevated PIVKA-II levels	97 (85.8)
PIVKA-II levels ≥ 400	62 (54.8)
PIVKA-II levels ≥ 4000	16 (14.2)
Child Class
A	38 (33.6)
B	56 (49.6)
C	19 (16.8)
Decompensated liver disease (ascites or encephalopathy)	71 (62.8)

IQR: Interquartile range; HC: Hepatitis C; HB: Hepatitis B; HD: Hepatitis D; MASLD: Metabolically-dysfunction-associated steatotic liver disease; PIVKA-II: Protein induced by vitamin K absence/antagonist-II.

Table 2 Logistic regression analysis of significant variables identified by univariate analysis

Variable	Sig	Exp(B)
Hepatitis B etiology	0.083	2.977
Hepatitis C etiology	0.581	0.744
White blood cell count (× 109/L)	0.130	1.097
Platelets count (× 109/L)	0.014	0.988
Total bilirubin (mg/dL)	0.264	0.929
Aspartate transaminase (IU/L)	0.311	0.994
Alanine transaminase (IU/L)	0.962	1.000
Alkaline phosphatase (IU/L)	0.009	0.994
PIVKA-II 400 or more	0.001	5.155

PIVKA-II: Protein induced by vitamin K absence/antagonist-II.