• abnormal prothrombin;
  • hepatocellular carcinoma;
  • PIVKA-π;
  • tumour marker.


We evaluated the clinical usefulness of a protein induced by vitamin K absence, antagonist-prothrombin (PIVKA-π), in detecting hepatocellular carcinoma (HCC) specifically in patients with liver cirrhosis, and the possible correlation between levels of PIVKA-π and pathological features of HCC. Plasma levels of PIVKA-π and α-fetoprotein (AFP) were measured in 628 patients with various diseases, including 253 with liver cirrhosis and 116 with HCC. PIVKA-π was detected (≥ 0.1 arbitrary unit/mL) in 54.3% of HCC and the concentration showed a positive correlation with the tumour size. As a screening test for the detection of HCC, PIVKA-π produced values comparable with those of AFP with a sensitivity, specificity and validity of 52.8, 98.8 and 51.6% respectively. Sixteen of 45 patients (37%) with HCC who had low AFP (< 100 ng/mL) levels were positive for PIVKA-π. No apparent relationship, however, could be found between the levels of PIVKA-π and the aetiology or pathological findings of HCC. These results suggest that PIVKA-π can be a reliable marker for detecting HCC in patients with liver cirrhosis.