This was a prospective study conducted at University Hospital, Khon Kaen University, Thailand. Data were collected from the HCC project. The inclusion criteria were patients 18 years or over with a high risk for HCC. The high risk for HCC was defined by the American Association for the Study of Liver Diseases (AASLD) guidelines for HCC management (17 (link)): cirrhosis or presence of liver nodule(s) of 1 cm or over in size. Those with pregnancy, obstructive jaundice, vitamin K, or warfarin administration and presence of extrahepatic malignancy were excluded. The study protocol was approved by the ethics committee in human research, Khon Kaen University, Thailand (HE621134). This study was a part of HCC project of Khon Kaen University, Thailand.
Eligible patients provided a written informed consent prior to study participation. Data were collected as follows: baseline characteristics, laboratory results, and radiographic findings. Baseline characteristics included age, sex, etiology of cirrhosis, comorbid diseases, and the Child-Pugh score for cirrhosis. Laboratory tests in the study were platelet count, serum creatinine, prothrombin time, liver function test, AFP, and PIVKA-II. All samples were tested for AFP and PIVKA-II by using a test kit (µTASWako i30; FUJIFILM Wako Pure Chemical Corporation). Radiographic findings were numbers of liver mass, largest mass size (cm), and portal vein invasion. HCC was diagnosed by either confirmation by pathological findings or radiographic findings of arterial hypervascularity followed by venous and/or delayed phase or washout of contrast (17 (link)).