الفهرس 
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Abstract
Hepatocellular carcinoma is one of the most common malignancies worldwide and the most common primary malignant tumor of the liver. It is the second leading cause of cancer related deaths in the world. It occurs most commonly on top of a cirrhotic liver which in Egypt is prevalence is due to chronic HCV infection.
When patients with obvious clinical symptoms come to the hospital for treatment, the HCC has already reached the advanced stages and is usually large in size. Given the subsequent rapid growth and vascular invasion, the prognosis then is very poor.
Diagnosis of HCC at earlier stages, thus improves patient outcomes. Currently, the most commonly used methods for screening and diagnosing HCC are ultrasound imaging and serum α-fetoprotein (AFP) concentration measurements, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity.
DKK-1 is a member of Dickkopf family & an inhibitor of β‐catenin‐dependent Wnt signaling pathway.The Wnt/β-catenin pathway regulates multiple cellular processes that are involved in the initiation, growth, survival, migration, differentiation, and apoptosis of HCC. The Wnt/β-catenin pathway has shown significant promise as a potential target for novel molecular therapies. Also, β-catenin mutation has been shown to affect the prognosis of HCC. DKK1 antagonize the Wnt/β-catenin pathway via a reduction in β-catenin and an increase in OCT4 expression.
The aim of this study is to assess the possible diagnostic role of serum DKK1 as a novel diagnostic marker of HCC & uses of DKK1 for prognosis of HCC.
The study was conducted upon 45 subjects who were divided into two groups: group I included 30 patients with liver cirrhosis , group II included 15 patients with HCC.
Our analysis showed that the mean levels of DKK1 was higher in patients with HCC compared with patients with liver cirrhosis (89.33 ± 35.5 vs 43.26 ± 26.74 ng/ml respectively) which was statistically significant ( P-value less than 0.0001). This strenghthen our conclusion about the possibility of using DKK1 as a novel biomarker for diagnosis of HCC.
Regarding alpha fetoprotein serum levels were much higher in the HCC group compared to cirrhotic patients.
The current study showed that there was highly statistically significant decrease in the mean levels of DKK1, 3 months post intervention (89.33 ± 33.5 vs 11.86 ±3.04 ng/ml , P value less than 0.001).