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 health 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 chronichepatitis or cirrhosis to HCC. Recent guidelines in the U.S. and Europe, however, have not endorsed the use of AFP or DCP as screening tools. Some doctors may occasionally order DCP for this purpose.
DCP is not sensitive or specific enough to be used to screen the general population for risk of developing HCC cancer.
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.
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.
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 acutehepatitis. 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.
This article was last reviewed on July 25, 2013. | This article was last modified on July 25, 2013.
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