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ISSN: 2392-1099
Clinical and Experimental Hepatology
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2/2020
vol. 6
 
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abstract:
Original paper

Study of Dickkopf-1 (DKK-1) in patients with chronic viral hepatitis C-related liver cirrhosis with and without hepatocellular carcinoma

Mona Kamal Eldeeb
1
,
Gehan Mahmoud Magour
1
,
Rania Nabil Bedair
1
,
Mohammed Mahmoud Shamseya
1
,
Mennatallah Abdelfattah Hammouda
2

  1. Medical Research Institute, Alexandria University, Egypt
  2. Pharos University in Alexandria, Egypt
Clin Exp HEPATOL 2020; 6, 2: 85–91
DOI: https://doi.org/10.5114/ceh.2020.95831
Online publish date: 2020/05/30
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Aim of the study
Dickkopf-1 (DKK-1) is a secreted protein which acts as an inhibitor of Wnt/β-catenin signaling. DKK-1 was found to be a helpful biomarker for many cancers including hepatocellular carcinoma (HCC). HCC is multifactorial in origin and its main etiology in Egypt is attributed to chronic hepatitis C virus (HCV) infection. Objectives: To assess the serum level and diagnostic performance of DKK-1 and α-fetoprotein (AFP) in Egyptian patients with chronic HCV-related liver cirrhosis with and without HCC.

Material and methods
80 subjects were divided into: a control group (group I, 20 healthy volunteers) and two patient groups: group II (HCV with liver cirrhosis, 30 patients), and group III, (HCV-related liver cirrhosis with HCC, 30 patients). Thorough physical examination, triphasic computed tomography, calculation of Child-Pugh score, laboratory investigations (complete blood picture, liver profile, hepatitis B surface antigen, anti-HCV antibodies, AFP (chemiluminometry) and DKK-1 (ELISA) were performed.

Results
There was a significant decrease in DKK-1 level in HCV patients with liver cirrhosis (group II) and HCV patients with HCC (group III) compared to the control group (group I) (p < 0.001). However, there was a significant increase in DKK-1 level in HCV patients with HCC (group III) compared to HCV patients with liver cirrhosis (group II) (p < 0.033). The ROC curve showed that DKK-1 has less sensitivity but higher specificity in HCV patients with HCC (group III) compared with HCV patients with liver cirrhosis (group II).

Conclusions
The combination of DKK-1 and AFP could further improve the diagnostic accuracy of HCV-related cirrhosis with or without HCC.

keywords:

hepatocellular carcinoma, hepatitis C virus, Dickkopf-1, α-fetoprotein
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