Diagnostic Study of Serum Dickkopf 1 Level and Alpha Fetoprotein L3 as Tumor Biomarkers in Hepatocellular Carcinoma

Abstract

Background: Alpha Fetoprotein (AFP) is now the most frequently applied tumour biomarker for the early diagnosis and clinical follow-up of HCC patients. Dickkopf 1 (DKK 1) is a protein that has a role in embryonic head morphogenesis. Several investigations revealed that DKK 1 regulates a variety of pathological and physiological processes. The aim of this work was to evaluate the diagnostic role of serum DKK 1 level and AFP- L3 as tumor markers in hepatocellular carcinoma. Methods: This observational research enrolled 60 participants aged above 18 years, group 1 include 10 healthy control participants, group 2 involved 25 cirrhotic cases and group 3 involved 25 cases diagnosed with HCC. All cases underwent taking of full history, clinical assessment, radiology, laboratory examination and specific investigations such as the tested two markers AFP-L3 and DKK1. Results: AFP-L3 had 84% sensitivity and 67.7% specificity, while DKK1 had sensitivity and specificity of 76% and 80% respectively to differentiate between cirrhotic and HCC cases, using a cut-off value of 8.62 ng/ml. two markers combination had specificity and sensitivity of 92%, 72% respectively and increase the accuracy for detection of HCC up to 82%. Conclusions: Both AFP-L3 and DKK1 could act as surrogate biomarkers for HCC and combination of two markers should be kept in mind to reach the optimum accuracy.