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Subject Area

Obstetrics and Gynecology

Article Type

Review

Abstract

Objectives To evaluate the clinical significance of serum Midkine (MDK) levels in the diagnosis of hepatocellular carcinoma (HCC) compared with alpha-fetoprotein (AFP). Background It was demonstrated that serum MDK levels are increased in cancer patients. So, it was suggested that MDK would likely be a novel marker for diagnosing tumors. In this study, we evaluated the significance of serum MDK levels in the diagnosis of HCC and early-stage HCC compared with AFP. Patients and methods The study was conducted on 90 patients who were divided into three groups: group I is the HCC group (n = 50), group II the liver cirrhosis group (n = 20), and group III is the control group (n = 20). Serum samples were obtained from all patients and were used to measure AFP and MDK levels. Receiver operating characteristic curves were drawn for both AFP and MDK in the diagnosis of HCC and early-stage HCC. Area under the curves (AUC) were calculated and were used to measure the sensitivity, specificity, and accuracy of both markers in the diagnosis of HCC and early HCC. Results AFP and MDK levels were increased in HCC over cirrhosis groups; and in HCC over control groups with a highly significant difference. MDK had the largest AUC in the diagnosis of both HCC (AUC = 1.00) and early-stage HCC (AUC = 0.829). In the diagnosis of HCC, serum MDK at a cutoff point of 0.62 ng/ml was 98.9% accurate compared with an accuracy of 73.3% for AFP at a cutoff point of 20.2 ng/ml. At a cutoff point of 0.92 ng/ml, serum MDK was 73.3% accurate in the diagnosis of early HCC compared with an accuracy of 65.6% for AFP at a cutoff point of 19.5 ng/ml. Conclusion Serum MDK could be a novel diagnostic tumor marker for the detection of HCC, particularly in patients at an early stage.

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