Email this page Print this article Was this page helpful?

DCP

Also known as: PIVKA II (protein induced by vitamin K absence or antagonists II)
Formal name: Des-gamma-carboxy prothrombin
Related tests: AFP, AFP-L3%, Tumor Markers

The Test

How is it used?

Des-gamma-carboxy prothrombin (DCP) is a relatively new test that may be ordered along with an imaging study, plus alpha-fetoprotein (AFP) and/or an AFP-L3% to evaluate whether a person with chronic liver disease has developed hepatocellular carcinoma (HCC). The DCP test is not considered a replacement for the AFP or AFP-L3% tests but gives the doctor additional information. These tests allow HCC to be detected as soon as possible and generally reflect tumor burden – the amount of cancer present.

Not every HCC will produce DCP. If DCP is initially elevated in a patient with HCC, then it can be used as a monitoring tool. It may be ordered along with an AFP to evaluate the effectiveness of treatment for HCC and used as a monitoring tool to detect cancer recurrence.

DCP is not sensitive or specific enough to be used to screen the general population for their risk of developing HCC cancer.

^ Back to top

When is it ordered?

The DCP test is not routinely ordered. It shows promise and gives the doctor additional information, but it has not yet gained widespread acceptance. The AFP test has been the tumor marker traditionally used to detect and monitor HCC, and it is the test most likely to be ordered.

DCP may be ordered periodically, along with imaging studies and AFP and/or AFP-L3% test, to detect HCC when it may still be treatable. When initially elevated, it may be ordered 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 a person for cancer recurrence.

^ Back to top

What does the test result mean?

Looking for reference ranges?

When DCP and AFP and/or AFP-L3% levels are increased in a person with chronic liver disease, they indicate an increased likelihood that a person has HCC. Since these tests are typically ordered periodically, changes over time can be evaluated. Increasing levels suggest the presence or recurrence of HCC. 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.

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.

^ Back to top

Is there anything else I should know?

Increases in DCP and/or AFP are not diagnostic of HCC. For a diagnosis, the tumor must be located - typically through the use of imaging scans - and cells from it must be examined under a microscope (also known as a biopsy).

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 you are taking warfarin to lower your 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. If you have vitamin K deficiency, DCP can also be increased.

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. The anticoagulant warfarin and some broad-spectrum antibiotics can affect test results.

^ Back to top