The Des-γ-carboxy-prothrombin Levels In Serum And Liver Tissue Of Hepatocarcinoma And Their Clinical Significance

Background/Aims: Des-y-carboxy-prothrombin (DCP) has been considered as a useful serum tumor marker for hepatocellular carcinoma (HCC). However, little information is available concerning the expression of immunoreactive DCP in cancerous and non-cancerous tissues. This study aims to simultaneously detect the serum DCP level and tissue immunoreactive DCP, and investigate the underlying mechanisms causing the elevation of serum DCP levels in HCC patient.Methods: Serum and tissue samples prepared from 92 patients with a single HCC nodule were subjected to clinicopathological study by measuring serum DCP levels with conventional enzyme immunosorbent assay (EIA) and performing immunohistochemical staining for tissue DCP.Results: The accuracy, sensitivity and specificity of serum DCP for HCC were 56.0%, 45.7% and 92.3% irrespectively, and the-positive rates of AFP for HCC was 41.3%. The positive rate was 66.3% when serum DCP was used in combination with AFP and was significantly higher than that when they were measured independently. Serum DCP levels correlated significantly with clinicopathological factors, including hepatitis markers, tumor differentiation, vascular invasion, intrahepatic metastasis, TNM stage, tumor size, tumor recurrence and patient survival (p<0.05). DCP immunohistochemical staining was positive in cancerous tissues for 68 (73.9%) patients and 14(14/17, 82.4%) patients with small-size HCC. In 24 (26.1%) patients, immunoreactive DCP was detected positively in non-cancerous tissues surrounding tumors. There was no apparent correlation between serum DCP values and the expression of DCP in HCC tissues; however, the positive rate of serum DCP level in patients with positive expression of DCP in non-cancerous tissues is significantly higher than that in patients with negative expression of DCP in non-cancerous tissues (p = 0.0398).Conclusions: Serum DCP is a useful tumor marker for HCC, the combined use of DCP and AFP can significantly improve the chance of identifying HCC. Serum DCP can reveal the malignancy of HCC and be used as a prognostic factor. DCP is a useful immunohistochemical marker, even in small-size HCC. The origin of elevated serum DCP may lie not only in HCC tissues but also in non-cancerous tissues and HCC lesion itself appears to influence the production of DCP in surrounding non-cancerous tissues.