Evaluation of serum dickkopf‑1 as a novel biomarker for hepatocellular carcinoma

Background Hepatocellular carcinoma (HCC) is a common worldwide cancer. α‑Fetoprotein (AFP) is a routinely used biomarker for HCC diagnosis, but with reduced clinical applicability due to low sensitivity and specificity. Dickkopf‑1 (DKK‑1) is vital in the differentiation, survival, apoptosis, and cell death. DKK‑1 has a potential oncogenic role in carcinogenesis. Aim In this study, we evaluated the diagnostic and prognostic performance of serum DKK‑1, AFP, and their combination in HCC. Patient and methods This study was done on 40 HCC patients, 24 liver cirrhosis patients, and 16 age‑matched and sex‑matched healthy controls. The patients were selected from the Tropical Medicine and Gastroenterology Department, Al‑Rajhi Liver Hospital. Results The optimum cutoff for DKK‑1 in HCC patients versus liver cirrhosis and control groups was more than 331 pg/ml with a sensitivity of 80.0% and specificity of 87.5%. The optimum cutoff for AFP was more than 8 IU/ml (sensitivity 77.5%, specificity 85.0%).The combination of the two markers had the best sensitivity (92.5%) in the diagnosis of HCC patients. Conclusion DKK‑1 levels was significantly higher in newly diagnosed HCC patients than in the nonmalignant control group. The combination of the two markers (DKK‑1 and AFP) enhanced the sensitivity.