DCP Test
DCP – The Test
Des-gamma-carboxy prothrombin (DCP) is an immature form of the coagulation protein, prothrombin. In the normal metabolism the prothrombin precursor undergoes a vitamin K dependent of carboxylation of 10 glutamicacid residues at the N-terminus to yield the native prothrombin. In the case of HCC this transformation is impaired, which results in an accumulation of DCP. DCP is also known as protein induced by vitamin K absence or antagonist II (PIVKA-II).
Schematic figure of DCP accumulation during HCC
In Japan DCP has been routinely used for many years as biomarker marker for HCC. Since 2007 DCP has been FDA-cleared in the USA for the risk assessment of HCC and CE-marked for the European market.
DCP is elevated in most HCC patients. Recently a novel high sensitive automated immunoassay for DCP has been developed. In a first study using this improved technique 295 HCC patients and 350 patients with chronic hepatitis and cirrhosis of various aetiologies have been investigated (Tamura et al. Dig Dis Sci 2010). As can be seen in the table below DCP showed a much higher sensitivity than AFP combined with a good specificity for the detection
of HCC.
| Diagnostic parameters of DCP versus AFP (Tamura et al. 2010) |
||
| AFP | DCP | |
| Cut-off | 200 ng/ml | 40 mAU/ml |
| Sensitivity | 34 % | 56 % |
| Specificity | 98 % | 95 % |
| Positive predictive value | 93 % | 91 % |
| Negative predictive value | 64 % | 72 % |
There is no correlation between expression of AFP and DCP. The combination of both tests is therefore reasonable to improve the accuracy of HCC diagnostics. Thus in another study an increased overall sensitivity could be demonstrated:
Positive patient number of DCP and AFP in patients with HCC (n=74)
The interpretation of positive AFP and DCP results is different. Although both markers are described to correlate with disease progression and tumor diameter, DCP has been shown to be a superior marker of further biological characteristics of HCC. Koike et al. reported in 2001 that DCP was the most significant predisposing factor for the development of portal vein invasion (PVI), an indicator of advanced HCC. HCC patients with elevated DCP but normal AFP tend to have more advanced HCC as shown by Okuda et al. in the same year.
DCP measurements are also very useful during the follow-up after the first treatment of tumors to predict recurrence.
To find a summarised presentation of DCP click here for the general flyer.
To find more technical information about the analytical technique, click here to visit the µTASWakoTM i30 page.
DCP - Ordering
For information concerning cost of DCP assay including related instrumentation and required material please contact Wako Chemicals GmbH at ++49/2131/311-176, or through e-mail at diagnostika@wako-chemicals.de.