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Year : 2019  |  Volume : 32  |  Issue : 1  |  Page : 359-362

Diagnostic value of serum Dickkopf-1 as a predictor of hepatocellular carcinoma in patients with liver cirrhosis

1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Gastroentology and Hepatology, Ahmed Maher Teaching Hospital, Cairo, Egypt

Correspondence Address:
Ahmed E El-Shandalaty
El-Santa, El-Gharbia, 31631
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_694_17

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Objective The aim of this study was to evaluate the significance of Dickkopf-1 (DKK-1) as a tumor marker for the diagnosis of hepatocellular carcinoma (HCC) in cirrhotic patients. Background HCC is a major health problem and its prognosis still remains dismal. Patients and methods This cross-sectional study included 50 cirrhotic patients with HCC, 50 cirrhotic patients without HCC, and 20 healthy age-matched and sex-matched participants as controls. All patients and controls were subjected to the following: full history taking, full clinical examination, and investigations as complete blood count, kidney function tests, liver function tests, serum α-fetoprotein (AFP), serum DKK-1, abdominal ultrasound, and triphasic computed tomography scan were done. Results DKK-1 level was significantly higher in the HCC group than in cirrhotic and control groups (P = 0.002). DKK-1 was significantly higher in multiple focal lesions (P = 0.010) and large focal lesions greater than 5 cm (P = 0.014). The best cut-off value of DKK-1 was 1.122 with a sensitivity of 80%, specificity of 77.1% with an area under curve of 0.810 and P value of less than 0.001. The validity of combined serum AFP and DKK-1 in the diagnosis of HCC showed an increased sensitivity of 92%, specificity of 77.1% with an area under curve of 0.882 and P value of less than 0.001. Conclusion DKK-1 was more sensitive and specific than AFP in the early diagnosis of HCC in cirrhotics. Combined use of DKK-1 and AFP increased the sensitivity and specificity for the diagnosis of HCC than serum AFP or DKK-1 alone.

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