Liver cancer grows silently with mild or no symptoms until advanced. In the absence of an effective treatment for advanced stage of
hepatic cancer hope lies in early detection, and screening for high-risk population. Among Egyptians viral
hepatitis is the most common risk factor for
hepatocellular carcinoma (HCC). The current work was designed to determine the level of
prothrombin induced by
vitamin K absence-II (
PIVKA-II) in sera of patients suffering from HCC and hepatitis C virus (HCV) patients being the most common predisposing factor for HCC. Our ultimate goal is diagnosis of HCC at its early stage. The current study was carried out on 83 individuals within three groups; Normal control, HCV and HCC groups. Patients were subdivided into cirrhotic and non-cirrhotic. Complete clinicopathological examination was carried out for each individual to confirm diagnosis. Individuals' sera were subjected to quantitative determination of
alpha-fetoprotein (AFP),
PIVKA-II and other parameters.
PIVKA-II proved to be superior to AFP for early detection of HCC patients being highly sensitive and specific. Furthermore it has the ability to discriminate between different histopathological grades of HCC and It has a powerful diagnostic validity to evaluate the
thrombosis of portal vein and to differentiate between early and late stages of HCC. The direct relation between the level of
PIVKA-II and the size of
tumor makes it an attractive tool for early HCC diagnosis and surveillance. Using the best cut-off value of AFP (>28), showed a sensitivity of (44%) and specificity of (73.3%). While cut-off value of
PIVKA-II (>53.7) showed 100% sensitivity and specificity.