Des-gamma carboxyprothrombin
Des-gamma carboxyprothrombin (DCP), also known as protein induced by vitamin K absence/antagonist-II (PIVKA-II), is an abnormal form of the
Diagnostic use
Hepatocellular carcinoma
A 1984 study first described the use of DCP as a marker of hepatocellular carcinoma (HCC); it was present in 91% of HCC patients, while not being detectable in other liver diseases. The DCP level did not change with the administration of vitamin K, suggesting a defect in gamma-carboxylation activity rather than vitamin K deficiency.[1] A number of subsequent studies have since confirmed this phenomenon.[2][3][4]
A 2007 comparison of various HCC tumor markers found DCP the least sensitive to risk factors for HCC (such as cirrhosis), and hence the most useful in predicting HCC.[5] It differentiates HCC from non-malignant liver diseases.[6] Moreover, it has been demonstrated that a combined analysis of DCP and Alpha-fetoprotein (AFP) can lead to a better prediction in early stages of HCC.[7]
Despite many years of use in Japan, only did a 2003 American study reevaluate its use in an American patient series. It also identified HCC at an earlier stage.[4]
Anticoagulant intoxication
A 1987 report described the use of DCP determination in the detection of intoxication with acenocoumarol, a vitamin K antagonist.[8]