Xia & He Publishing Inc. Jan 24 2026 Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, particularly in regions with high hepatitis B virus prevalence. Early detection is challenging due to the limited sensitivity of conventional biomarkers such as alpha-fetoprotein (AFP). Protein induced by vitamin K absence or antagonist-II (PIVKA-II), an abnormal prothrombin variant, has emerged as a promising serological biomarker with significant diagnostic,