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AIM: To study the plasma des-γ-carboxy protein C activity,antigen and prothrombin levels in patients with liver diseases and their clinical significance.METHODS: Plasma protein C activity (PC:C) was detected by chromogenic assay and antigen (PC:Ag) and des-γ-carboxy protein C (DCPC) were detected by ELISA. Total prothrombin and unabsorbed prothrombin in plasma were detected by ecarin chromogenic assay.RESULTS: Compared with the control, the levels of PC:C and PC:Ag in patients with hepatocellular carcinoma (HCC)and liver cirrhosis (LC) were lower (PC:C: 104.65±23.0%,62.50±24.89%, 56.75±20.14%, PC:Ag: 5.31±1.63 μg/mL,2.28±1.15 μg/mL, 2.43±0.79 μg/mL, P＜0.05). The levels of PC:Ag in patients with acute viral hepatitis (AVH) also was lower (2.98±0.91 μg/mL, P＜0.01), but PC:C was close to the control (93.76±30.49%, P＞0.05). The levels of DCPC in patients with HCC were remarkably higher (0.69±0.29 μg/mL,1.18±0.63 μg/mL, 0.45±0.21 μg/mL, P＜0.05) and its average was up to 50% of total PC:Ag. But those of DCPC in patients with AVH were not significantly different from the control.The levels of total prothrombin were lower in patients with LC, but higher in patients with HCC. The levels of unabsorbed prothrombin were predominantly higher than those of other groups.CONCLUSION: PC:C and PC:Ag in patients with liver diseases (except PC:C in AVH) were lower. The total prothrombin was lower in patients with LC. The higher level of unabsorbed prothrombin may be used as a scanning marker for HCC. DCPC may be used as a complementary marker in the diagnosis of HCC.