الفهرس 
NATURAL HISTORY OFOnly 14 pages are availabe for public view
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Abstract
Background: Hepatocellular carcinoma (HCC) is the sixth most common malignant disease and the third leading cause of cancer-related death worldwide. HCC accounts for 70–80% of all liver cancers. Across all countries, 5-year overall survival is only 3–5%. α-Fetoprotein (AFP) is the best serum biomarker for diagnosis of HCC, but sensitivity is low (25–65%) at the commonly used cut off value of 20 ng/mL, particularly in detection of early-stage HCC. Dickkopf-1 (DKK1), a secretory antagonist of the canonical Wnt signaling pathway was identified in 1998. Aim: Evaluation of the role of Dickkopf-1 as non-invasive marker for diagnosis of Hepatocellular Carcinoma in HCV-infected patients and comparing it with healthy controls. Subjects: This study included 100 Egyptian patients recruited from Hepatology wards and outpatient clinics at Ain Shams University Hospitals, in addition to 50 healthy controls. Study subjects were divided into 3 groups: HCC, chronic liver disease, and control group. Serum samples from all study subjects were collected for detection of DKK-1 using commercially available DKK-1 ELISA kit. Results: showed that the three groups were statistically matched as regard age and gender. All three groups showed non-significant difference as regard DKK-1 serum levels. As regard diagnostic performance of DKK-1 as a solitary marker for diagnosis of HCC, ROC curves showed a low sensitivity and specificity, which showed no advantage over AFP. Recommendations: Considering the use of DKK-1 as a complimentary serum biomarker in screening for HCC, to compensate for the disadvantage of AFP as regard its variable sensitivity values.