Increase of Serum Des‐gamma‐Carboxy Prothrombin in Alcoholic Liver Disease Without Hepatocellular Carcinoma

Abstract

The purpose of this study is to determine serum des-gamma-carboxy prothrombin (DCP) levels in benign liver diseases by a new sensitive method, and to demonstrate the elevation of serum DCP in alcoholic liver disease (ALD) without hepatocellular carcinoma (HCC). Median values of serum DCP were 16.2 mAU/ml (range: 3.2 to 1570 mAU/ml) in ALD and 16.7 mAU/ml (1.2 to 75.4 mAU/ml) in viral liver disease (VLD). Using the cut-off value of 40 mAU/ml as a tumor marker for HCC, 21% (11/52) was positive in ALD and 2% (1/57) was positive in VLD (p = 0.0014, Fisher's exact probability test), and 27% (9/33) was positive in alcoholic liver cirrhosis and 3% (1/39) was positive in viral liver cirrhosis (p = 0.0042, Fisher's exact probability test). The positive rate of DCP was significantly (p < 0.001, Spearman's rank correlation test) correlated with the severity of liver disease in ALD. Serum vitamin K level was not decreased in cases with ALD. In a demonstrable case, serum DCP was decreased after abstinence and was increased again after the beginning of ethanol intake, suggesting the involvement of ethanol to the elevation of serum DCP in ALD. In conclusion, serum DCP was significantly elevated in ALD, compared with VLD, although the mechanism of the elevation of DCP was not clarified. Ethanol intake may act, in part, on the increase of serum DCP in ALD.

Intestinal absorption of mixed micellar phylloquinone (vitamin K1) is unreliable in infants with conjugated hyperbilirubinaemia: implications for oral prophylaxis of vitamin K deficiency bleeding

“…34 Another caveat is that PIVKA-II may simply reflect liver dysfunction, because raised levels in the absence of demonstrable vitamin K deficiency are occasionally found in adults with chronic liver disease. [42][43][44][45] Our results argue strongly against either possibility because in 15/18 infants, the initially raised PIVKA-II declined after the administration of vitamin K at rates consistent with previous estimates of the plasma disappearance of PIVKA-II. 34 46 The wide range of but low median serum K 1 concentrations after oral administration of Konakion MM is clear evidence of a variable and often low efficiency of intestinal absorption in infants with cholestasis.…”

Des-&#947;-Carboxy Prothrombin (DCP) as a Potential Autologous Growth Factor for the Development of Hepatocellular Carcinoma

“…Some studies revealed that DCP is not only found in the HCC tissues, but also in the non-cancer tissues surrounding HCC and even in some benign liver diseases, such as acute hepatitis and chronic hepatitis [20,23,24]. These observations imply the complicated causes and mechanisms of DCP production.…”

Imaging of focal nodular hyperplastic-like nodules in alcoholic liver cirrhosis patients using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging

“…The background liver showed cirrhosis (a). The nodule showed a slightly increased cell density and sinusoidal dilatation in comparison to the background liver tissue (b) the elevation of PIVKA II has not been clarified [6]. Ethanol intake and the following vitamin K deficiency may act, in part, due to an increased serum PIVKA II level in alcoholic liver disease.…”