PIVKA-II (des-carboxylated prothrombin, DCP) is an abnormal form of prothrombin that can appear in cases of vitamin K deficiency or in patients treated with warfarin or phenprocoumon. These des-carboxylated prothrombins are functionally defective and cannot bind calcium or phospholipids. Measuring PIVKA-II allows early detection of biochemical vitamin K deficiency before the results of conventional coagulation tests change or bleeding occurs. PIVKA-II is absent in healthy individuals, but it may appear in liver disease or liver cancer even without vitamin K deficiency. This test helps in diagnosing and predicting outcomes for patients with hepatocellular carcinoma (HCC), as well as monitoring them during therapy.




