الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is a common form of cancer in the world and is the third leading cause of cancer-related death. More than 80% of its incidence is found in developing countries; rates are more than twice as high in men compared with women. HCC is the most common form among primary liver cancers occurring worldwide, about 70–85% of liver tumors.
Aim of the Work: This study was aimed to evaluate the clinical significance of serum Dickkopf-1 (DKK1) as a diagnostic and prognostic marker in hepatocellular carcinoma.
Patients and Methods: This was a prospective study that was conducted on 60 patients and 30 healty control subjects recruited from Al Sahel Teaching Hospital. Results: Regarding the demographic data, there was no statistically significant difference found between 3 groups regarding age and sex. Tumor Size was < 2cm in 10.0% of HCC patients, 2 – 3 cm in 56.7% of them & > 5 cm in 33.3% of HCC patients. While number of tumors was Single in
33.3% of HCC patients, 2 – 3 in 30.0% & Multiple masses in 36.7% of patients. PV thrombosis was reported in 30% of patients. Incidence of child score c in our study was significantly higher in HCC group when compared with Liver Cirrhosis group. According to this study, there was Non statistically significant correlation Between DKKA1 (pg/ml) & each of Age, HB, WBCs, Platelets, ALT, AST, Creat, Urea, Albumin, INR, Bilirubin and AFP in both all patients & Liver Cirrhosis groups. While for HCC group, there was Non statistically significant correlation Between DKKA1(pg/ml), Age, HB, Platelets, ALT, Creat, Urea, Albumin, INR, Bilirubin and AFP, but there
was statically significant Positive correlation Between DKKA1(pg/ml), WBCs and AST. Serum DKK1 was significantly higher in HCC group comparing with liver cirrhosis group and control group. According to our study, ROC curve showed that the best cut off point of DKKA1 to detect Liver Cirrhosis group was > 264.9 pg/ml with sensitivity of 56.67%, specificity of 86.67%, PPV of 81.0%, NPV of 66.7%. Another ROC curve showed that the best cut off point of DKKA1 to detect HCC group was found > 453 with sensitivity of 83.33%, specificity of 93.33%, PPV of 92.6%, NPV of 84.8%. Assessment of diagnostic performance of serum DKK1 when used in discriminating group (HCC) from group (Liver Cirrhosis), revealed a better diagnostic performance of DKK1) as the best ROC cut-off for DKK1 was > 1674.8 ng/mL, this had a diagnostic sensitivity of 50%, specificity 96.67%, positive predictive value 93.7%, negative predictive value 65.9%. Conclusion: In conclusion, our study suggests that DKK-1 may be a key regulator in HCC progression, a promising potential therapeutic target for HCC. We also demonstrated that serum DDK-1 could be a useful marker for diagnosing HCC