Background Early diagnosis of hepatocellular carcinoma enhances
its effective management. Aim Evaluation of Midkine as a
biomarker for diagnosis of hepatocellular carcinoma. Methods: 90
subjects devided into three groups, Group I included 40 HCV
patients with liver cirrhosis, Group II included 40 HCV cirrhotic
patients with hepatocellular carcinoma and Group III included 10
healthy subjects as a control group. Demographic, laboratory and
imaging data were collected. All cirrhotic cases were evaluated by
Child-Pugh and MELD scores while BCLC score and Okuda
staging were applied for hepatocellular carcinoma cases. Serum
Midkine was measured by ELISA technique. Results HCC group
had significant elevation in Midkine level compared when to
Cirrhotic and Control groups (3.5±2.5 ng/ml versus 1±0.7 ng/ml
and 0.1±0.1 ng/ml) (p = 0.000). No significant correlations were
found between Midkine and age, sex, site or size of focal lesion,
Child classification, MELD score, Okuda staging or BCLC score.
ROC analysis showed that the best cut-off value for Midkine was
1.33ng/ml and for AFP was 41.3ng/ml. Area Under the Curve was
higher in Midkine than AFP (0.921 and 0.79 respectively) with
higher specificity of AFP than Midkine (97.5% and 82.5%
respectively) and higher sensitivity of Midkine than AFP (87.5 and
62.5% respectively). By combination of serum AFP and Midkine,
AUC was 0.94 with specificity 97.5 % and sensitivity 87.5%.
Conclusion Midkine may be a sensitive biomarker for diagnosis of hepatocellular carcinoma and
combination between alpha-fetoprotein and Midkine increases the accuracy in diagnosis |
