DCP-Decarboxy Prothrombin PIVKA-II
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Primarily used as a tumor marker for Hepatocellular Carcinoma (HCC)
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🧪 DCP (Des-γ-carboxy prothrombin) / PIVKA-II
📌 What is DCP (PIVKA-II)?
Des-gamma-carboxy prothrombin (DCP), also known as PIVKA-II (Protein Induced by Vitamin K Absence or Antagonist-II), is an abnormal form of prothrombin (clotting factor II) produced by malignant liver cells when there is a defect in vitamin K–dependent carboxylation.
🎯 Why is it Tested?
- Primarily used as a tumor marker for Hepatocellular Carcinoma (HCC)
- Helps diagnose, monitor treatment response, and detect recurrence of liver cancer
- May be elevated even when Alpha-fetoprotein (AFP) levels are normal
- Used in combination with AFP for improved diagnostic accuracy in liver cancer
🧪 Test Details
Aspect | Details |
|---|---|
Full Name | Des-gamma-carboxy prothrombin (DCP) / PIVKA-II |
Other Names | Abnormal Prothrombin, Protein Induced by Vitamin K Absence or Antagonist-II |
Sample Type | Blood (serum) |
Fasting Required | ❌ Not required (but follow specific lab instructions if under treatment) |
Methodology | Chemiluminescent immunoassay (CLIA) or ELISA |
Reference Range | Usually < 40 mAU/mL (lab-specific reference values apply) |
Turnaround Time | 24–48 hours |
🧠 Clinical Significance
Condition | Role of DCP |
|---|---|
Hepatocellular Carcinoma (HCC) | DCP is elevated in many HCC cases |
Chronic Liver Disease (e.g. cirrhosis) | May have moderate elevation, but not diagnostic |
Vitamin K Deficiency or Warfarin Use | Can falsely elevate DCP values |
🔬 When is it Ordered?
- Screening in patients at high risk for liver cancer (e.g. cirrhosis, HBV, HCV)
- Diagnosis of suspected HCC
- Monitoring treatment response or detecting recurrence after surgery or ablation
- Staging and prognostic evaluation in liver cancer patients
🔗 Recommended Conjunct Tests
Test | Purpose |
|---|---|
Alpha-Fetoprotein (AFP) | Used in combination with DCP for HCC screening |
Liver Function Tests (LFT) | Evaluate hepatic function |
Abdominal Ultrasound / MRI | Imaging to confirm liver mass |
HBsAg / Anti-HCV | To identify viral hepatitis as a risk factor |
Vitamin K Level (if suspecting interference) | To rule out nutritional cause of elevation |
📊 Interpretation Guide
DCP Level | Clinical Interpretation |
|---|---|
Normal (< 40 mAU/mL) | Unlikely HCC (if AFP also normal) |
Elevated (> 40–100 mAU/mL) | Suggests possible HCC; consider imaging + AFP |
High (> 100 mAU/mL) | Strong suspicion of HCC or progression/recurrence |
📌 Always interpret alongside clinical findings, imaging, AFP, and liver function.
⚠️ Important Notes
- Warfarin and Vitamin K deficiency can cause false-positive results.
- Not used as a screening test in general population—only for high-risk individuals.
- Elevated in some non-HCC liver tumors but typically at lower levels.
📍 Summary
Feature | DCP / PIVKA-II |
|---|---|
Marker For | Hepatocellular carcinoma (HCC) |
Sample Type | Serum |
Fasting | Not required |
False Positives In | Warfarin use, Vitamin K deficiency |
Complementary Tests | AFP, imaging, LFTs, HBV/HCV tests |
Monitoring Use | Treatment response and cancer recurrence |
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