A 44 year old man complaints of abdominal distention and nausea since few months. USG of abdomen shows a growth on right lobe of the liver. Tumor marker study shows the evidence of primary hepatocellular carcinoma. All of the following tumor markers will be raised in this patient, EXCEPT:
AFP is a serum tumor marker for HCC; however, it is only increased in approximately one-half of patients. The lens culinaris agglutinin-reactive fraction of AFP (AFP-L3) assay is thought to be more specific. The other widely used assay is that for des-gamma-carboxy prothrombin (DCP), a protein induced by vitamin K absence (PIVKA-2). Many other assays have been developed, such as glypican-3, but none have greater aggregate sensitivity and specificity. Ref: Carr B.I. (2012). Chapter 92. Tumors of the Liver and Biliary Tree. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds),Harrison's Principles of Internal Medicine, 18e.
Alpha fetoprotein
Alpha 2 macroglobulin
PIVKA-2
DCP