Serum Dickopff 1 as a Novel Biomarker in Hepatocellular Carcinoma Diagnosis and Follow Up After Ablative Therapy

Figures & data

Table 1 Demographic and Clinical Data of All Studied Patients

		Group Ba		Group Bb		Chi-squared
N	%	N	%	Test	P-value
Age	Range	47 – 67		42 – 70		T: 0.192	0.664
Mean ± SD	53.65 ± 5.65		54.60 ± 7.88
Sex	Male	15	75	12	60	χ^2: 1.026	0.311
Female	5	25	8	40
Residence	Rural	18	90	17	85	χ^2: 0.231	0.633
Urban	2	10	3	15
Family history of HCC		15	75	16	80	χ^2: 0.138	0.705
DM		11	55	9	45	χ^2: 0.401	0.527
Smoking		8	40	7	35	χ^2: 0.112	0.744
Coffee (3 cups/day)		2	10	3	15	χ^2: 0.231	0.633
Hematemesis		15	75	13	65	χ^2: 0.728	0.393
Hepatic encephalopathy		12	60	11	55	χ^2: 0.101	0.749
Rt hypchondrial pain		14	70	12	60	χ^2: 0.439	0.507
Ascites		13	65	11	55	χ^2: 0.421	0.519
Jaundice		15	75	9	45	χ^2: 3.752	0.053
Anti HCV		17	85	20	100	χ^2: 3.243	0.072
HBsAg		4	20	1	5	χ^2: 2.057	0.151

Table 2 Comparison Between Different Groups as Regards to Serum Alfa Fetoprotein

	Range	Mean±SD	F	P-value
Group A	1.3–20	11.06±5.19	87.695	0.001*
Group Ba	18–1250	293.43±318.03
Group Bb	21–1456	815.65±490.32
Group C	1–2.3	1.43±0.43
Group D	8.5–17.5	12.33±3.02
Tukey’s test
	Group A	Group Ba	Group Bb	Group C
Group Ba	0.001*
Group Bb	0.001*	0.001*
Group C	0.328	0.001*	0.001*
Group D	0.968	0.001*	0.001*	0.309

Note: *Statistically significant.

Table 3 Comparison Between Different Studied Groups Regarding Serum DKK1 Level

	Serum DKK1		ANOVA
Range	Mean±SD	F	P-value
Group A	1–1.43	1.28±0.1	58.239	0.001*
Group Ba	2.17–2.45	2.30±0.08
Group Bb	2.15–2.35	2.38±0.33
Group C	0.54–0.96	0.73±0.12
Group D	0.54–3.33	1.83±0.88
Tukey’s test
	Group A	Group Ba	Group Bb	Group C
Group Ba	0.001*
Group Bb	0.001*	0.107
Group C	0.001*	0.001*	0.001*
Group D	0.001*	0.001*	0.001*	0.001*

Note: *Statistically significant.

Table 4 Comparison Between Serum Level of AFP in Group Bb Before Intervention (MWA and RFA) and One Month After intervention

Group B	Serum AFP Group Bb		Paired t-test
Range	Mean±SD	T	P-value
Before	21–1456	815.65±490.32	10.633	0.002*
After	6.7–1312	332.98±444.74

Note: *Statistically significant.

Table 5 Comparison in Group Bb of Serum Level of DKK1 Before and After Intervention

Group B	Serum DKK1 Group Bb		Paired t-test
Range	Mean±SD	T	P-value
Before	2.15–3.35	2.38±0.33	12.373	0.001*
After	0.55–3.74	1.37±1.24

Note: *Statistically significant.

Table 6 Serum DKK1 in Both Recurrence and Completely Ablated Cases Group Bb

Recurrence	Serum DKK1 Group Bb		t-test
Range	Mean ± SD	T	P-value
Yes	3.10–3.74	3.45 ± 0.25	109.853	0.001*
No	0.55–0.90	0.68 ± 0.13

Note: *Statistically significant.

Table 7 Serum Level of AFP and DKK1 in Recurrent Cases and Completely Ablated Lesions After One Month in Group Bb (HCC)

Recurrence in Group Bb	Serum α-Fetoprotein		Serum DKK1
N	%	N	re%
Recurrent cases	4	20	5	25
Completely ablated cases	16	80	15	75

Table 8 Level of Serum DKK1 in Group D (AFP Negative Group)

	Negative		Positive
Number	%	Number	%
Serum AFP	20	100.0	0	0.0
Serum DKK1 (Median for > 2.2) with cut off > 2.15	6	30.0	14	70.0

Table 9 ROC Curve Between Recurrent and Non-recurrent HCC After Ablation

ROC Curve Between Recurrent and Not Recurrent
	Cut off	Sens.	Spec.	PPV	NPV	Accuracy
Serum_DKK1	>2.1	100.0	100.0	100.0	100.0	100.0
Serum α-fetoprotein	> 400	80.0	60.0	67.0	75.0	70.0

Table 10 Specificity and Sensitivity of Serum DKK1 Cut off Level of 1.4 ng

Group A	Cut off	Sens.	Spec.	PPV	NPV	Accuracy
Serum_DKK1	> 1.4	90.0	100.0	100.0	92.0	83.0

Table 11 Specificity and Sensitivity of Serum α-Fetoprotein Cut off Level of > 8.5 ng/mL

Group A	Cut off	Sens.	Spec.	PPV	NPV	Accuracy
Serum α-fetoprotein	> 8.5	60.0	70.0	80.0	45.0	62.0