Sharaf, A., El-Badrawy, E., Khalifa, N., Abdel Monem, S., Dawod, H. (2016). Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma. Afro-Egyptian Journal of Infectious and Endemic Diseases, 6(4), 156-165. doi: 10.21608/aeji.2016.9974
Ahmed Sharaf; El-Said El-Badrawy; Naglaa Khalifa; Sameh Abdel Monem; Hosam Dawod. "Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma". Afro-Egyptian Journal of Infectious and Endemic Diseases, 6, 4, 2016, 156-165. doi: 10.21608/aeji.2016.9974
Sharaf, A., El-Badrawy, E., Khalifa, N., Abdel Monem, S., Dawod, H. (2016). 'Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma', Afro-Egyptian Journal of Infectious and Endemic Diseases, 6(4), pp. 156-165. doi: 10.21608/aeji.2016.9974
Sharaf, A., El-Badrawy, E., Khalifa, N., Abdel Monem, S., Dawod, H. Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma. Afro-Egyptian Journal of Infectious and Endemic Diseases, 2016; 6(4): 156-165. doi: 10.21608/aeji.2016.9974
Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma
1Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
2Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background and study aim: Hepatocellular carcinoma (HCC) accounts for 70 - 80% of all liver cancers and the 5-year survival is only 3 - 5%. This bad prognosis is due to the lack of an effective method for early diagnosis. So, only 30 - 40% of patients with HCC are suitable for curative treatments at the time of diagnosis. Thus, there is a great need for tools to diagnose HCC early especially in cirrhotic patients. The aim of this work is to assess the validity of serum DKK1 as a diagnostic marker for HCC and to assess prognostic value of serum DKK1 in predicting treatment response, complication and survival in HCC patients. Patients and Methods: This study included Session [CurrentTestPartID] Patients divided into two groups. Group A: consisted of 30 patients with post hepatitic C and/or B liver cirrhosis. Group B: consisted of 30 patients with HCC on top of post hepatitic C and/or B liver cirrhosis. Group B patients underwent either radiofrequency ablation or ethanol injection. Clinical assessment, routine laboratory evaluation, CT studies and measurement of serum alpha-fetoprotein (AFP) and DKK1 were performed to all patients and repeated to group B patients 1 and 3 months after treatment. Results: The optimum cut off value of DKK1 for diagnosis of HCC was 4.3 ng/mL (AUC 0.89, sensitivity 66.7% and specificity 96.6%) (P<0.001). While, the optimum cut off value for AFP was > 101 ng/mL with 90% sensitivity and 75.9% specificity (p<0.001). Testing of both DKK1 and AFP increased the diagnostic accuracy for HCC (AUC 0.901, sensitivity 93.3%, and specificity 75.9) (P<0.001). Serum DKK1 level significantly decreases after HCC treatment with either radio-frequency ablation or ethanol injection (P<0.001). Conclusion: Testing of both DKK1 and AFP significantly increased the diagnostic accuracy for HCC. Meanwhile, DKK1 can be used alone for HCC diagnosis even in HCC with inconclusive AFP. DKK1 has a promising prognostic value and can be used for follow up of HCC patients who underwent loco-regional treatment.
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