PIVKA-II Test: Booking, Price, and Results
About PIVKA-II Test
| Field | Value |
|---|---|
| Also Known As | DCP (Des-gamma-carboxy prothrombin), Decarboxy prothrombin, Prothrombin induced by vitamin K absence or antagonist-II |
| Sample Type | Serum (venous blood) |
| Fasting Required | No fasting needed; eat and drink normally |
| Report Time | 2 days |
| Recommended For | All genders; primarily adults with chronic liver disease or at high risk for liver cancer |
| Price | Starting at ₹5,000 |
What is a PIVKA-II Test?
The PIVKA-II test measures the level of an abnormal protein in the blood that is linked to liver cancer and certain liver conditions. PIVKA-II stands for Protein Induced by Vitamin K Absence or Antagonist-II. It is also called DCP (des-gamma-carboxy prothrombin) or decarboxy prothrombin. A small blood sample is taken from a vein and analysed in a laboratory. Doctors typically order this test when they suspect hepatocellular carcinoma (HCC), which is the most common form of primary liver cancer, or to monitor patients who already have chronic liver disease.
What Does a PIVKA-II Test Measure?
The PIVKA-II test detects an abnormal form of prothrombin, a protein that helps blood clot. In a healthy liver, prothrombin is correctly modified using vitamin K. When the liver is affected by cancer or severe dysfunction, this process breaks down, and the abnormal, unmodified protein enters the bloodstream. Raised PIVKA-II levels in blood can therefore signal liver cancer or other liver-related conditions.
| Component | What It Measures |
|---|---|
| PIVKA-II (DCP) | Abnormal prothrombin protein released when normal liver processing fails; used as a tumour marker for hepatocellular carcinoma |
Why is a PIVKA-II Test Done?
A doctor may order this test for several reasons, ranging from investigating symptoms to monitoring a known liver condition.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to request a PIVKA-II test:
- Persistent tiredness or unexplained weakness
- Unintentional weight loss
- Pain or swelling in the abdomen
- Jaundice (yellowing of the skin or eyes)
- Loss of appetite
- Dark urine or pale stools
Conditions This Test Can Help Detect
PIVKA-II levels may be elevated in several conditions, including:
- Hepatocellular carcinoma (HCC), the most common type of primary liver cancer
- Vitamin K deficiency
- Obstructive jaundice (blocked bile flow from the liver)
- Intrahepatic cholestasis (bile flow blockage within the liver)
- Sepsis (a severe response to infection)
- Alcoholic liver disease
Unlike AFP (alpha-fetoprotein), PIVKA-II is a highly specific marker, meaning its levels are not usually raised by pregnancy, general liver cirrhosis, or germ cell tumours.
PIVKA-II Test for Chronic Disease Monitoring
For patients with long-term liver conditions such as chronic hepatitis B or C, or liver cirrhosis, the PIVKA-II test is a useful surveillance tool for HCC. Levels can be tracked over time to monitor disease progression or treatment response. A significant fall in DCP levels after procedures such as surgery, chemoembolisation (blocking blood supply to a tumour), or radiofrequency ablation (heat-based tumour treatment) suggests a positive treatment response. Rising levels may indicate that the cancer has returned. Doctors may advise monitoring every few months for high-risk patients.
How to Prepare and What to Expect
Preparation for this test is straightforward, and the sample collection process is quick and simple.
Do You Need to Fast?
No fasting is required before a PIVKA-II test. You can eat and drink as normal before your appointment. If you are also having additional tests on the same day, check with your doctor whether those require fasting.
Practical Tips Before Your Test
Here are a few things to keep in mind before your appointment:
- Bring details of your clinical history, including your symptoms, past test results, and any relevant family history, as these details are needed to complete your test documentation
- Tell your doctor about all medicines you are taking, particularly warfarin (a blood-thinning medicine), antibiotics, or vitamin K supplements.
- Avoid excessive alcohol intake before the test, as alcohol can affect liver function.
- Drink plenty of water to stay well hydrated before sample collection.
- Wear a loose-fitting top with short or rolled-up sleeves for easy access to your arm.
Step-by-Step Procedure
The PIVKA-II test procedure is a standard blood draw. Here is what to expect:
- A trained phlebotomist (a person who draws blood) will seat you comfortably and check your details.
- A band is tied around your upper arm to make the vein easier to see. You may be asked to make a fist.
- The skin over the vein is cleaned with a disinfectant solution.
- A sterile needle is gently inserted into the vein, and approximately 3 mL of blood is collected into an SST gel tube.
- The needle is removed, and a small bandage is applied to the site. The procedure takes only a few minutes.
- The sample is refrigerated and sent to the laboratory, where serum is separated and analysed by enzyme immunoassay (EIA) to measure the PIVKA-II concentration.
Factors That Can Affect Accuracy
Certain factors may influence your test results. These include:
- Use of warfarin or other anticoagulants (blood-thinning medicines).
- Vitamin K deficiency due to poor diet, malnutrition, or antibiotic use.
- Liver conditions such as cholestasis (blocked bile flow) or cirrhosis.
- Acute illness, inflammation, or infection may occasionally affect test interpretation.
- Improper sample handling or delays in transporting the sample to the laboratory.
Understanding Your PIVKA-II Test Results
Your results should always be reviewed by your doctor, who will consider your full medical history before drawing any conclusions. The table below shows general reference ranges for PIVKA-II:
| Parameter | Normal | Raised | Unit |
|---|---|---|---|
| PIVKA-II | Below 40 | 40 and above | mAU/mL |
Note: Some laboratories use gender-specific ranges (approximately 15-42 mAU/mL in males and 12-39 mAU/mL in females). The exact cut-off may vary slightly between laboratories and across methods.
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Some conditions and medicines can affect PIVKA-II levels independently of liver cancer:
- Warfarin use causes a sharp rise in PIVKA-II as the drug blocks vitamin K activity in the liver. Always inform your doctor if you are warfarin or other blood-thinning medicines.
- Obstructive jaundice, severe infections such as sepsis, and some non-cancerous liver conditions may also increase PIVKA-II levels. In some cases, the values may overlap with those seen in Hepatocellular Carcinoma, so additional clinical evaluation and laboratory tests are often required.
- Alcohol-related liver disease and abnormal liver function markers, including raised ALP (alkaline phosphatase) and bilirubin, may also be associated with higher PIVKA-II levels.
How to Maintain Healthy Levels
These general lifestyle measures may help support liver health:
- Include vitamin K-rich foods in your diet, such as leafy green vegetables like spinach, kale, and broccoli.
- Limit alcohol consumption to reduce strain on the liver.
- Attend regular follow-up appointments with your doctor if you have a chronic liver condition to allow early detection of any changes.
Lupin Diagnostics PIVKA-II Test Price and Home Collection
The PIVKA-II test is available at Lupin Diagnostics starting at ₹5,000, with home sample collection offered across multiple cities. The table below lists approximate PIVKA-II test prices in major Indian cities based on aggregator data:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 5000 |
| CHENNAI | 5000 |
| HYDERABAD | 5000 |
| KOLKATA | 5000 |
| NAVI MUMBAI | 5000 |
| PUNE | 5000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking a PIVKA-II test online is straightforward:
- Select the PIVKA-II test on the Lupin Diagnostics website.
- Choose your city and preferred time slot
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within 2 days.
Home Collection
Home collection for the PIVKA-II test is available across cities. A trained phlebotomist will visit your home at a convenient time. All samples are processed in NABL-accredited laboratories under strict quality protocols. Once ready, your digital report will be delivered securely via email or WhatsApp.
Frequently Asked Questions
The PIVKA-II test measures abnormal prothrombin protein in the blood and is primarily used as a tumour marker to diagnose and monitor hepatocellular carcinoma (HCC), the most common form of primary liver cancer. It can also help identify conditions such as vitamin K deficiency and obstructive jaundice.
AFP (alpha-fetoprotein) is another tumour marker used for liver cancer, but it can also be raised in conditions such as cirrhosis and pregnancy. PIVKA-II is more specific to HCC and is not elevated in those conditions. Using both markers together improves the accuracy of diagnosis, as PIVKA-II can detect HCC in patients whose AFP levels are normal.
Yes, certain medicines can raise PIVKA-II levels. Warfarin (a blood thinner) is the most significant example, as it inhibits vitamin K activity and increases PIVKA-II levels. Antibiotics and vitamin K supplements can also affect results. Always inform your doctor about every medicine you are taking before the test.
This test is recommended primarily for adults with chronic liver conditions such as cirrhosis or chronic hepatitis B or C, who are at a higher risk of developing HCC. Doctors may also order it for patients showing symptoms such as persistent fatigue, abdominal swelling, or unexplained weight loss that could point to a liver-related concern.
Yes, raised PIVKA-II levels do not always mean liver cancer is present. Conditions such as warfarin use, obstructive jaundice, sepsis, and vitamin K deficiency can also cause elevated readings. Your doctor will consider the results alongside other tests, imaging, and your clinical history before reaching a conclusion.
If you have a chronic liver condition and are being monitored for HCC, your doctor may recommend repeating the PIVKA-II test every few months. The frequency depends on your specific condition, your level of risk, and your doctor's assessment. Always follow your doctor's guidance on how often to test.
PIVKA-II Test: Booking, Price, and Results
