Clinical significance and diagnostic value of serum dickkopf-1 in patients with hepatocellular carcinoma

Scand J Gastroenterol. 2016 Sep;51(9):1133-7. doi: 10.3109/00365521.2016.1172337. Epub 2016 May 10.


Background: Hepatocellular carcinoma (HCC) is one of the most prevalent cancers worldwide. It has been widely established that the early detection of HCC enables more treatment options and translates to improved survival.

Aim: To assess the diagnostic accuracy of DKK1 as a serum protein marker for HCC by examining its diagnostic sensitivity and specificity in HCC.

Methods: We analyzed data for 50 patients with hepatitis C virus (HCV) related HCC as the studied group. Twenty patients with chronic hepatitis C and 20 patients with HCV-related liver cirrhosis will serve as control group. DKK1 was measured in serum by ELISA. We used receiver operating characteristics (ROC) to calculate its diagnostic accuracy.

Results: We assessed serum DKK1 in 90 participants: 50 with HCC (studied group), 20 with chronic HCV infection, and 20 with liver cirrhosis (as control group). Serum concentration of DKK1 was significantly higher in HCC group and values did not differ significantly between the two control groups. We performed multivariate regression analysis using AFP level, number of focal lesions, focal lesion size and Portal vein thrombosis as an independent variable. ROC curves showed the optimum diagnostic cut off was 1.5 ng/mL (sensitivity 67.5%, specificity 89.3%).

Conclusion: Serum DKK1 could potentially be used for early diagnosis of HCC and complement measurement of AFP in the diagnosis of HCC.

Keywords: AFP; DKK 1; HCC; hepatitis C.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Carcinoma, Hepatocellular / blood*
  • Egypt
  • Female
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / pathology
  • Humans
  • Intercellular Signaling Peptides and Proteins / blood*
  • Linear Models
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / blood*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • alpha-Fetoproteins / analysis


  • Biomarkers, Tumor
  • DKK1 protein, human
  • Intercellular Signaling Peptides and Proteins
  • alpha-Fetoproteins