Background and Aim. Identification of sensitive biomarkers to improve early diagnosis of HCC is needed. We aimed to evaluate serum midkine (MDK) as a biomarker for HCC diagnosis.Patients and Methods. 40 HCCs, 30 liver cirrhosis patients, and 30 healthy subjects were enrolled. Serum MDK using ELISA was measured in all included subjects.Results. Serum MDK was significantly elevated in HCC group compared to cirrhotic and healthy control groups (0.625 versus 0.15 and 0.125 ng/mL), respectively. No significant association was found between MDK and either BCLC stage, tumor diameter, tumor number, or AFP level. Receiver operating characteristic curve showed that best cutoff for MDK and AFP was 0.387 and 88.5 ng/mL, respectively. Area under the curve of MDK was significantly larger than that of AFP (0.941 versus 0.671). The sensitivity of MDK at 0.387 ng/mL for HCC diagnosis was significantly higher than that of AFP at cutoffs 20, 88.5, and 200 ng/mL (92.5 versus 62.5, 40, and 25%), respectively. Sensitivity of MDK reached 93.3% in patients with AFP <20 ng/mL. Moreover, MDK at 0.387 ng/mL had significant better sensitivity than AFP at 20 ng/mL in distinguishing HCC from BCLC 0/A (90 versus 40%).Conclusion. Serum MDK might be a potential diagnostic marker for HCC particularity in its early stages.
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机译：背景和目标。需要鉴定敏感的生物标志物以改善肝癌的早期诊断。我们旨在评估血清中期因子（MDK）作为HCC诊断的生物标志物。患者和方法。招募了40例HCC，30例肝硬化患者和30例健康受试者。使用ELISA方法对所有纳入受试者的血清MDK进行了测定。与肝硬化组和健康对照组相比，HCC组的血清MDK显着升高（分别为0.625、0.15和0.125μng/ mL）。在MDK和BCLC分期，肿瘤直径，肿瘤数目或AFP水平之间均未发现明显关联。接收器工作特性曲线表明，MDK和AFP的最佳截止分别为0.387和88.5 ng / mL。 MDK曲线下的面积明显大于AFP（0.941对0.671）。 MDK在0.387 ng / mL时对HCC诊断的敏感性显着高于AFP在20、88.5和200 ng / mL时的敏感性（分别为92.5、62.5、40和25％）。 AFP <20μng/ mL的患者MDK的敏感性达到93.3％。此外，在区分HCC和BCLC 0 / A时，MDK在0.387μng/ mL时的敏感性要比AFP在20μng/ mL时好得多（90％对40％）。血清MDK可能是早期肝癌特异性的潜在诊断指标。
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