BACKGROUND The total des-gamma-carboxyprothrombin (DCP) produced in hepatocellular carcinoma (HCC) and the surrounding non-cancer liver tissue was estimated and the correlation between tissue DCP and serum DCP levels was examined. PATIENTS AND METHODS Forty patients with a single primary HCC nodule served as the subjects. The DCP was quantified by electrochemiluminescence immunoassay and the tissue volumes were estimated by computed tomography (CT). RESULTS The mean tissue DCP in the cancer tissue, non-cancer tissue and the whole HCC specimen was 147,400, 20,200 and 190,000 mAU, respectively, which correlated positively with the serum DCP level (r2 = 0.657, 0.452, and 0.684, respectively). The DCP expression levels in the cancer and non-cancer liver tissue were also confirmed by immunohistochemical detection of DCP. CONCLUSION The elevation of serum DCP levels in HCC patients is influenced by DCP production not only in the cancer tissue, but also in the surrounding non-cancer liver tissue.