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.
Samuell, E., Abdel-Aziz, A., Shehata, A., Abdel-Wahab, M., & Elmougy, R. (2024). The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients. Asian Pacific Journal of Cancer Prevention, 25(6), 2185-2191. doi: 10.31557/APJCP.2024.25.6.2185
MLA
Ereny Samuell; Abdel-Aziz F Abdel-Aziz; Ahmed S. Shehata; Mohamed Abdel-Wahab; Rehab A Elmougy. "The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients". Asian Pacific Journal of Cancer Prevention, 25, 6, 2024, 2185-2191. doi: 10.31557/APJCP.2024.25.6.2185
HARVARD
Samuell, E., Abdel-Aziz, A., Shehata, A., Abdel-Wahab, M., Elmougy, R. (2024). 'The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients', Asian Pacific Journal of Cancer Prevention, 25(6), pp. 2185-2191. doi: 10.31557/APJCP.2024.25.6.2185
VANCOUVER
Samuell, E., Abdel-Aziz, A., Shehata, A., Abdel-Wahab, M., Elmougy, R. The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients. Asian Pacific Journal of Cancer Prevention, 2024; 25(6): 2185-2191. doi: 10.31557/APJCP.2024.25.6.2185
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