Determination of PIVKA-II levels helps detect Vitamin K deficiency before routine coagulation test results change or bleeding occurs. PIVKA-II is not normally present, but in people with liver disease and malignant liver disease, PIVKA-II can be present even though the body is not deficient in vitamin K. PIVKA-II levels are determined to aid in the diagnosis. Diagnosis and prognosis in patients with HCC and monitoring of patients with HCC during treatment.