Evaluation of serum dickkopf-1 as a tumor biomarker for diagnosis and prognosis of hepatocellular carcinoma in patients with cirrhotic liver

Abstract

Background: Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Diagnosis of hepatocellular carcinoma (HCC) should occur in an early stage, so that the patient benefits from earlier diagnosis, through treatment using established algorithms. The research aimed to evaluate the significance of Dickkopf-1 (DKK1) as a tumor biomarker for the diagnosis and prognosis of HCC in cirrhotic cases. Methods: This prospective, randomized, controlled research was carried out on 120 individuals who were classified as follow: Group I: comprised 40 cases with cirrhotic liver and HCC. Group II: comprised 30 cases with cirrhotic liver without HCC. Group III: comprised 30 cases with chronic hepatitis without cirrhosis. Control group: comprised 20 healthy individuals. Serum DKK-1 level were measured to all participants but for HCC patient group it was measured before intervention and one month after intervention (with the first CT after intervention). Results: Six cases of group I underwent microwave ablation, 13 cases underwent RFA, 20 cases underwent trans-arterial chemotherapy (TACE) and one patient underwent liver transplantation. Thirteen cases of group I were well ablated following loco regional therapy and no recurrence or de novo lesions appeared during follow up. Residual activity or de novo lesions or recurrence appeared in 26 cases who required second cession of ablation. alpha-fetoprotein (AFP) in group I was ranging between 3.6 to 2400 ng/ml with mean 698.870 ng/ml. It was higher in group I than groups II, III, and IV. DKK1 level was significantly higher in group I than groups II, III and IV, also, was significantly higher in group II than groups III and IV and it was significantly higher in group III than group IV. Conclusions: Serum DKK1 could serve as a potential diagnostic biobiomarker for HCC. DKK1 might be utilised as a predictor of therapeutic ablation outcome in cases with hepatocellular carcinoma.