الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a rather common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients.
Tumor markers are substances synthesized and secreted by the malignant cells and they are not normally found and they are not biologically active if present as they present in much smaller amounts, few of them are produced in a sufficient large proportions, so they can be used as serum markers of tumors and they become helpful in screening, diagnosis and follow up of cases.
The Dickkopf is a family of four secreted glycoproteins (DKK1,DKK2, DKK3 and DKK4) that serve as regulators to Wnt/ β-catenin signaling.
Hyperactivation of Wnt/β-catenin signaling pathway has been implicated in HCC and with Dickkopf-1 as a downstream target of this pathway, it can be speculated that Dickkopf-1 may enter the circulation via active secretion from HCC tumors.
The aim of this study is to verify the possibility of using Dickkopf- 1 level as a tumor marker for hepatocellular carcinoma.
The study included 90 subjects divided into three groups: group I was 50 patients with HCV related hepatocellular carcinomas group II was 20 patients with HCV related liver cirrhosis and group III was20 patients of chronic HCV.
Serum Dickkopf-1 levels were significantly high in HCC patients than LC group but there was no significant difference with CHC group .
This study showed that DKK1 levels in the HCC group were affected by the tumor size and PVT.
The sensitivity and specificity of DKK1 for selective detection of the HCC group over cirrhotic group, was 67.5 % and 89.3 % respectively at a cut off value of 1.53 ng /mL
The sensitivity and specificity of AFP for selective detection of the HCC group over cirrhotic group, was 65.4% and 76.7 % respectively at a cut off value of 15.4 ng /Ml.
So Dickkopf-1 level appears to be additional marker for HCC detection.