PIVKA-II (Protein induced by vitamin K absence or antagonist-II) is an incomplete blood clotting protein produced by liver cancer cells. Imagine our liver as a factory that produces substances that help stop bleeding when we get injured. One of these important substances is called prothrombin. To create complete prothrombin, this factory needs vitamin K, just like an essential ingredient. However, when the liver has cancer, the cancer cells in the liver produce a faulty, incomplete "clotting substance" called PIVKA-II. The PIVKA-II test helps detect this faulty "substance" in the blood, thereby providing an early warning of liver cancer risk. This test is especially useful for people at high risk of liver cancer, such as those with cirrhosis or chronic hepatitis B or C. In other words, if your liver already has "problems," checking to see if the factory is producing faulty "substances" will help detect cancer earlier, when treatment can be most effective.