Des‐γ‐carboxy prothrombin ratio measured by P ‐11 and P ‐16 antibodies is a novel biomarker for hepatocellular carcinoma

Serum tumor markers, including α‐fetoprotein ( AFP ) and des‐γ‐carboxy prothrombin ( DCP ), are currently used in the diagnosis of hepatocellular carcinoma ( HCC ). There is, however, an aberrant increase in serum DCP in patients with obstructive jaundice, vitamin K deficiency or who are taking warfarin, resulting from a problem with the current methodology for measurement of this marker. This study aimed to elucidate the utility of a new biomarker, NX‐PVKA , for early diagnosis of HCC . A total of 96 patients were included in the HCC group. The control group included 138 liver cirrhosis ( LC ) patients without HCC . Serum concentrations of conventional DCP , AFP , AFP‐L 3 and NX‐PVKA were measured. The NX‐PVKA ratio was calculated by dividing DCP by NX‐PVKA . In patients not taking warfarin, the area under the curve values of DCP , NX‐PVKA ratio, AFP and AFP‐L 3 were 0.715, 0.690, 0.737 and 0.654, respectively, confirming the clinical utility of these markers in detecting HCC . In cases with DCP  > 35 mAU/mL in particular, a significant increase in the NX‐PVKA ratio was observed in patients with HCC . In those cases, the cut‐off value for the NX‐PVKA ratio that was optimized by the receiver operating characteristic ( ROC ) curve was 1.15. In addition, the sensitivity and specificity for diagnosing HCC were 69.2% and 75.9%, respectively. Patients with HCC had higher NX‐PVKA ratios compared to patients with LC taking warfarin ( P  =   0.063). These results suggest that, when used in combination with DCP , the NX‐PVKA ratio is a promising novel marker for the detection of HCC .