Medical diagnosis: Better test for the liver

肝胆速递

http://www.naturechina.com.cn/nchina/2012/120905/full/nchina.2012.61.html
Published online: 5 September 2012 | doi:10.1038/nchina.2012.61

Medical diagnosis: Better test for the liver

Felix Cheung

Abstract

The biomarker DKK1 helps boost the sensitivity of existing screening tests for liver cancer
Original article citation
Shen, Q. et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study. Lancet Oncol. 13, 817–826 (2012).
Introduction

Liver cancer is the sixth most frequently diagnosed cancer and the third most frequent cause of cancer deaths worldwide. More alarmingly, half of all new cases and deaths occur in China.

Current blood tests use α-fetoprotein (AFP) as a serum marker for diagnosing liver cancer, but the sensitivity is low (25–65%). Wenxin Qin at Shanghai Jiao Tong University and co-workers have now used a novel and reliable serum marker called dickkopf-1 (DKK1) to improve the sensitivity of AFP tests.

DKK1 is a secreted protein thought to be involved in cancer development. The researchers assessed blood samples from 831 patients, revealing varying serum levels of DKK1. Patients diagnosed with liver cancer showed significantly more DKK1 in serum than healthy controls.

To test the performance of DKK1, the researchers repeated the experiment on another group of 453 different patients. They found that the sensitivity of using DKK1 and AFP together (73.3–87.4%) was higher than that of using either DKK1 (69.1–70.9%) or AFP (54.4–57.8%) alone.

More importantly, the researchers were able to use DKK1 measurements to distinguish patients with liver cancer, chronic hepatitis B infection or liver cirrhosis from healthy controls. This enhancement in screening could help save millions of lives by facilitating early treatment.

The authors of this work are from:
State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital and MOE Key Laboratory of Carcinogenesis and Cancer Invasion, Fudan University, Shanghai, China; Institute of Biomedical Sciences, Fudan University, Shanghai, China; Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China; Department of Infectious Diseases, First Affiliated Hospital of Soochow University, Suzhou, China.
Reference

    Shen, Q. et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study. Lancet Oncol. 13, 817–826 (2012).

肝胆速递

发布时间：2012 | DOI：10.1038/nchina.2012.61

医生诊断：更好的测试，为肝

费利克斯长

抽象

有助于提高现有的筛检肝癌的敏感性生物标志物DKK1
原创文章引用
沉强，等。血清DKK1作为蛋白质生物标志物对肝癌的诊断：一个大型的多中心研究。柳叶刀肿瘤学。 13，817-826（2012）。
介绍


肝癌是第六个最常见的癌症，全世界癌症死亡的第三个最常见的原因。更令人担忧的是，有一半的新病例和死亡发生在中国。

目前的血液测试，使用α-甲胎蛋白（AFP）作为诊断肝癌的血清标志物，但敏感性低（25-65％）。文欣秦在上海交通大学和他的同事已经使用了一个新的和可靠的血清标志dickkopf-1（DKK1），以提高灵敏度的AFP测试。

DKK1是一种分泌蛋白被认为参与在癌症的发展。研究人员评估了从831例患者的血液样本，揭示了不同的血清DKK1。确诊为肝癌的患者表现出显著高于健康对照组DKK1血清中。

的DKK1的性能测试中，研究人员反复实验，在另一组453个不同的病人。他们发现，使用DKK1和AFP（73.3-87.4％）的敏感性高于可以使用DKK1（69.1-70.9％）或AFP（54.4-57.8％），单独的。

更重要的是，研究人员能够使用DKK1测量，区分患者与健康对照组的肝癌，慢性乙肝病毒感染或肝硬化。此增强功能的筛查，早期治疗提供便利，可以帮助拯救数百万人的生命。

这项工作的作者来自：
国家重点实验室癌基因及相关基因医学院附属仁济医院，上海肿瘤研究所，医学院，上海交通大学，上海，中国肝脏外科，中山医院肝癌研究所和教育部重点实验室的发生，癌细胞的侵袭，复旦大学，上海，中国生物医学科学研究所，复旦大学，上海，中国东方肝胆外科医院，第二军医大学，上海，中国;第一附属医院传染​​科，中国苏州的东吴大学。
参考

    沉强，等。血清DKK1作为蛋白质生物标志物对肝癌的诊断：一个大型的多中心研究。Lancet肿瘤学。 13，817-826（2012）。