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

Authors Younis YS, Alegaily HS, Elagawy W, Semeya AA, Abo-Amer YEE, El-Abgeegy M, Mostafa SM, Elsergany HF, Abd-Elsalam S

Received 6 June 2019

Accepted for publication 30 October 2019

Published 17 December 2019 Volume 2019:11 Pages 10555—10562

DOI https://doi.org/10.2147/CMAR.S218532

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Antonella D'Anneo


Yehia Sadek Younis,1 Hatem Samir Alegaily,1 Waleed Elagawy,2 Atteyat Aboelmaged Semeya,3 Yousry Esam-Eldin Abo-Amer,3 Mohamed El-Abgeegy,4 Sahar Mohamed Mostafa,4 Heba Fadl Elsergany,4 Sherief Abd-Elsalam5

1Hepatology, Gastroenterology and Infectious Diseases, Benha Faculty of Medicine, Qalybia, Egypt; 2Department of Tropical Medicine, Faculty of Medicine, Port Said University, Port Fouad, Egypt; 3Hepatology, Gastroenterology and Infectious Diseases, Mahala Hepatology Teaching Hospital, Gharbia, Egypt; 4National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 5Department of Tropical Medicine, Faculty of Medicine, Tanta University, Gharbia, Egypt

Correspondence: Sherief Abd-Elsalam
Department of Tropical Medicine, Faculty of Medicine, Tanta University, El-Geish Street, Tanta, Egypt
Tel +201095159522
Email Sherif_tropical@yahoo.com

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.

Keywords: serum Dickopff 1, aphafeto protein, hepatocellular carcinoma, radiofrequency ablation, microwave ablation, TACE

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