To evaluate effectiveness of treatment for hepatocellular carcinoma (HCC), a type of liver cancer, if the level of des-gamma-carboxy prothrombin is elevated prior to treatment; to monitor for recurrence of HCC
Des-gamma-carboxy prothrombin (DCP)
Des-gamma-carboxy prothrombin (DCP)
Also Known As
PIVKA II (protein induced by vitamin K absence or antagonists II)
Formal Name
Des-gamma-carboxy prothrombin
This article was last reviewed
on
This article waslast modified
on
May 18, 2018.
At a Glance
Why Get Tested?
When To Get Tested?
Periodically when you have been treated for HCC
Sample Required?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
None
Accordion Title
Common Questions
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How is it used?
A des-gamma-carboxy prothrombin (DCP) test may be used along with other tumor markers such as an alpha-fetoprotein (AFP) and/or an AFP-L3% to monitor the effectiveness of treatment for hepatocellular carcinoma (HCC), a type of liver cancer. It may also be used to monitor for recurrence of HCC after successful treatment.
Not every HCC will produce DCP. If DCP is initially elevated in person who has been diagnosed with HCC, then it can be used as a monitoring tool. The DCP test is not considered a replacement for the AFP or AFP-L3% tests, but gives the healthcare practitioner additional information. These tests generally reflect tumor burden – the amount of cancer present.
In Japan, DCP is being used, along with AFP and/or AFP-L3% to periodically screen those considered to be at high risk of progressing from chronic hepatitis or cirrhosis to HCC. Guidelines in the U.S. and Europe, however, have not endorsed the use of AFP or DCP as screening tools. However, some healthcare practitioners may this test to aid in the risk assessment of patients with chronic liver disease for progression to HCC in conjunction with other laboratory findings and imaging studies.
DCP is not sensitive or specific enough to be used to screen the general population for risk of developing HCC cancer.
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When is it ordered?
The DCP test is not routinely ordered. However, it may initially be ordered when an individual is diagnosed with HCC. If the initial level is elevated, it may then be ordered periodically during and after treatment of HCC to evaluate the effectiveness of treatment and ordered periodically along with an AFP and/or AFP-L3% to monitor for cancer recurrence.
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What does the test result mean?
When the DCP level is increased in a person diagnosed with HCC, it means that the cancer is producing this substance and the test can be used as a tumor marker. Since the test is typically ordered periodically, changes over time can be evaluated. Decreasing concentrations in someone who is being treated for HCC suggest response to treatment. Levels that stay the same or increase after treatment indicate that the treatment has not been effective. Increasing levels after treatment has been completed suggest recurrence of HCC.
A person can have HCC without having elevated DCP. The tumor may not produce DCP or it may be small enough that it is not producing significant amounts.
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Is there anything else I should know?
Increases in DCP and/or AFP are not diagnostic of HCC. For a diagnosis, the tumor may be located through the use of imaging scans. Sometimes a biopsy may be performed and cells from it examined under a microscope to aid in establishing a diagnosis.
DCP can also be elevated because of acute hepatitis. In persons with chronic hepatitis, mild increases in DCP are common, although not as commonly as with AFP, and generally not to as high levels.
If someone is taking the anticoagulant warfarin to lower the risk of blood clots, DCP will be markedly increased, since this drug works by blocking the action of vitamin K and leads to production of the same abnormal form of prothrombin as occurs in HCC. DCP can also be increased with vitamin K deficiency.
A person with a persistent vitamin K deficiency or jaundice due to a liver obstruction may have elevated DCP levels that are not due to HCC. Some broad-spectrum antibiotics can affect DCP test results.
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How long will it take for results?
This depends on the laboratory performing the test. The test requires specialized equipment and is not offered by every laboratory. The blood sample will usually be sent to a reference laboratory and it make take a few days before results are available.
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If I have liver cancer in my family, should I be tested for DCP?
DCP is not intended to be used to screen the general population or those who are healthy. A DCP test may be occasionally performed if you have chronic liver disease and your healthcare practitioner wants the additional information it may offer.
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If I have hepatitis, should I have a DCP test performed?
You should talk to your healthcare practitioner. Guidelines by the American Association for the Study of Liver Diseases (AASLD) do not recommend using DCP as a screening test for the development of HCC, but it is used for this purpose in some other parts of the world.