1. The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients.
- Author
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Samuell E, Abdel-Aziz AF, Shehata AS, Abdel-Wahab M, and Elmougy RA
- Subjects
- Humans, Male, Female, Middle Aged, Prognosis, Liver Cirrhosis diagnosis, Follow-Up Studies, Adult, Hepacivirus isolation & purification, Early Detection of Cancer methods, Aged, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular virology, Liver Neoplasms diagnosis, Liver Neoplasms virology, Liver Neoplasms blood, Intercellular Signaling Peptides and Proteins blood, Axl Receptor Tyrosine Kinase, Receptor Protein-Tyrosine Kinases, Biomarkers, Tumor blood, Proto-Oncogene Proteins, Hepatitis C, Chronic complications
- Abstract
Background: Standard tools are not sensitive enough for hepatocellular carcinoma (HCC) early detection. This study aimed to evaluate the accuracy of dickkopf-1 (DKK1) and soluble Axl (sAxl) and their combined for early differentiating of HCC from premalignant benign liver diseases., Methods: A total of 210 chronic hepatitis C (CHC) patients (55 fibrotic, 45 cirrhotic and 110 HCC) were enrolled. Both DKK1 and sAxl were tested using ELISA for all participants., Results: HCC patients were accompanied by a significant increase (P<0.05) in DKK1 (5.38±2.05 ng/mL) and sAxl (178.02±49.39 ng/mL) compared to patients with fibrosis (2.16±0.6, 97.63±19.71 ng/mL, respectively) and cirrhosis (2.62±0.8, 121.84±34.66 ng/mL, respectively). Both DKK1 (AUC=0.852) and sAxl (AUC=0.882) had a good diagnostic accuracy in separating HCC from all non-HCC patients. Multiplying DKK1 with sAXL yielded values that significantly (P=0.0001) increased in patients who developed HCC (674.3 (434.2-1413.9)) versus fibrotic (204.9 (161.7-262)) and cirrhotic (254.4 (205.4-343.7)) patients. This model improves HCC diagnostic performances [AUC=0.921; sensitivity 90.9%, specificity 87%, PPV 88.5%, NPV 89.7% and efficiency 89.1%]. Elevated DKK1×sAxl values were associated with aggressive tumor features including multiple nodules, large size, Child-Pugh and BCLC late stages., Conclusions: combined use of DKK1×sAxl is simple and feasible HCC diagnostic model that could enhance HCC diagnostic accuracy and could replace AFP in follow up of patients with premalignant diseases.
- Published
- 2024
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