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Subject Area

Ophthalmology

Article Type

Review

Abstract

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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