<p>Serum Dickopff 1 as a Novel Biomarker in Hepatocellular Carcinoma Diagnosis and Follow Up After Ablative Therapy</p>

Abstract

Background: This study aimed to evaluate the role of Dickopff 1 (DKK1) serum levels as a marker for early detection of hepatocellular carcinoma (HCC) and to compare it with alphafetoprotein (AFP) after non-surgical intervention (microwave ablation, radiofrequency ablation) in HCC. Patients and methods: This prospective study was conducted in Al-Mahalla hepatology teaching hospital from June 2015 to June 2017. One hundred and twenty patients were included. They were classified into four groups: Group A: 40 patients with chronic liver disease; Group B: 40 patients with HCC which were divided into 2 main sub groups, group Ba which included HCC patients who were not eligible for ablative therapy and group Bb which included HCC patients who were eligible for ablative therapy; Group C: 20 healthy control subjects matched for age and sex; Group D: 20 HCC patients with negative AFP, DKK1 was done for them. Results: There was a highly significant difference (p < 0.001) between groups regarding serum level of Dickpoff 1 with mean of 1 ng/mL in group A (cirrhotic), 2.38 ng/mL in group B (HCC), and 1.83 ng/mL in group D (AFP negative HCC) in comparison to control group C with mean of 0.54 ng/mL. There was a highly statistically significant difference (p value less =0.01) in the studied groups regarding serum Dickpoff 1 before and after intervention with a mean of 2.38 ng/mL before intervention and mean of 1.37 ng/mL after 1 month of intervention. Conclusion: Serum Dkk-1 has higher sensitivity, specificity, and accuracy in early diagnosis of HCC than AFP.

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

“…On comparing the four studied groups as regard the alphafetoprotein (AFP), its level was significantly higher in group I than group II, III and IV which showed that AFP level can distinguish HCC cases from cirrhosis cases, HCC cases from chronic viral hepatitis without cirrhosis cases and HCC cases from controls. This result agreed with Erdal et al, (2016) and Younis et al, (2019) who showed that AFP level can distinguish HCC cases from cirrhosis cases, and HCC cases from controls [37][38] . There was a significant correlation between smoking and serum level of DKK1which agreed with Jorde et al, (2019) who concluded that smokers had significantly higher DKK1 than non-smokers [39] .…”

HCC biomarkers – state of the old and outlook to future promising biomarkers and their potential in everyday clinical practice

“…The glycoprotein Dickkopf-1 (DKK-1), expressed mainly in the placenta and embryonic tissues, is an antagonist of the Wnt/β-catenin signaling pathway and is elevated in several cancer types. DKK-1 shows higher efficacy for detecting HCC than AFP in phase 4 trials ( 206 – 208 ), but midkine is more precise than DKK-1 in cirrhotic HCV patients ( 209 ). A combination of Golgi protein 73, AFP, and Dickkopf-1 increases the sensitivity and specificity of HCC detection ( 210 ).…”

Dickkopf-1 Promotes Angiogenesis and is a Biomarker for Hepatic Stem Cell-like Hepatocellular Carcinoma

“…DKK-1 expression has also been reported to be elevated in HCC tissues [ 20 ], and DKK-1 is dysregulated in various other malignant tumors, such as pancreatic cancer, colorectal cancer, multiple myeloma, and chronic lymphocytic leukemia [ 21 , 22 , 23 , 24 ]. The diagnostic value of serum DKK-1 levels for HCC has previously been determined [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. However, although DKK-1 expression is activated in HpSC-HCC with the activation of Wnt signaling, DKK-1 itself is known to inhibit the Wnt signaling pathway, and the role of DKK-1 expression in the process of HpSC-HCC development remains elusive.…”