The Combined Use of Dickkopf-1 and Soluble Axl Improves Hepatocellular Carcinoma Diagnostic Efficacy in Hepatitis C Patients

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 25; no. 6; pp. 2185 - 2191
• Main Authors: Samuell, Ereny, Abdel-Aziz, Abdel-Aziz F, Shehata, Ahmed S, Abdel-Wahab, Mohamed, Elmougy, Rehab A
• Format: Journal Article
• Language: English
• Published: Thailand West Asia Organization for Cancer Prevention 01.06.2024
• Subjects: Adult; Aged; Axl Receptor Tyrosine Kinase; Biomarkers, Tumor - blood; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - virology; Early Detection of Cancer - methods; Female; Follow-Up Studies; Hepacivirus - isolation & purification; Hepatitis C, Chronic - complications; Humans; Intercellular Signaling Peptides and Proteins - blood; Liver Cirrhosis - diagnosis; Liver Neoplasms - blood; Liver Neoplasms - diagnosis; Liver Neoplasms - virology; Male; Middle Aged; Prognosis; Proto-Oncogene Proteins; Receptor Protein-Tyrosine Kinases; HCC; soluble Axl; HCV; early detection; DKK1
• ISSN: 1513-7368; 2476-762X
• DOI: 10.31557/APJCP.2024.25.6.2185

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. 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. 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. 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.