Blue Simple Medical Clinic Presentation 6Blue Simple Medical Clinic Presentation 6


PIVKA-II, The Des-γ-carboxy prothrombin (DCP) test, sometimes called the PIVKA-II test, is a blood test that is mostly used concerning liver health, specifically for the diagnosis and surveillance of hepatocellular carcinoma (HCC), a prevalent form of liver cancer.

PIVKA-II: What is it? 

Protein Induced by Vitamin K Absence, or Antagonist-II, is referred to as PIVKA-II. It is an aberrant form of prothrombin, a blood-clotting protein that is generated when vitamin K levels are low or when the protein’s normal activity is disrupted. PIVKA-II levels that are elevated may be a sign of liver illness, particularly liver cancer.

Clinical Importance of HCC (Hepatocellular Carcinoma):

The HCC biomarker most frequently employed is the PIVKA-II test. PIVKA-II is a helpful tool for early identification because people with this kind of cancer frequently have elevated levels of it, even in the early stages. 

In individuals with HCC, it can also be used to track the effectiveness of treatment and the advancement of the illness.
Distinguishing This Liver Disease from Others:

Alpha-fetoprotein (AFP) levels, another often used marker in liver disease, may also be raised in cirrhosis or hepatitis, two benign liver disorders that PIVKA-II levels can assist in differentiating from HCC.

Examining and Monitoring:

The PIVKA-II test can be used as a component of a routine screening program in high-risk populations (e.g., those with cirrhosis, chronic hepatitis B or C infections) to identify HCC at an early, more manageable stage.

Test Procedure: 

Sample Collection: A blood sample, usually taken from an arm vein, is needed for the test. Laboratory Analysis: To determine the amount of PIVKA II, the blood sample is subjected to immunoassay analysis.

Analysis of the Findings

Normal Range: PIVKA-II levels below a specific threshold (e.g., 40 mAU/mL) are typically considered normal. However, the reference range can vary depending on the laboratory.
Elevated Levels: PIVKA-II levels that are elevated (usually greater than 40 mAU/mL) may indicate the existence of HCC, but other diagnostic tests, like imaging studies and biopsies, are required to confirm the diagnosis.

Benefits and Drawbacks

Specificity for HCC: PIVKA-II reduces false positives associated with other liver disorders since it is more specific to HCC than AFP.
Early Detection: By identifying HCC early on, treatment results can be enhanced.
False Positives: Elevated PIVKA-II levels can also be caused by illnesses other than HCC, such as vitamin K insufficiency.
Variable Sensitivity: The PIVKA-II test’s sensitivity varies and it might not be able to identify every instance of HCC, especially when the tumor is small or in its early stages.


The PIVKA-II test is a useful diagnostic and therapeutic tool for hepatocellular carcinoma. It helps with early detection and therapy monitoring and provides specificity for liver cancer. To guarantee an accurate diagnosis and the best possible care for the patient, it should be utilized in concert with further diagnostic techniques and clinical assessments.

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