Significance of serum DKK1 as a diagnostic biomarker in hepatocellular carcinoma

Evaluation of: Shen Q, Fan J, Yang XR et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study. Lancet Oncol. 13(8), 817-826 (2012). Hyperactivation of the Wnt/beta-catenin signaling pathway has been implicated in cancers, including hepatocellular carcinoma (HCC). Dickkopf-1 (DKK1) is a secretory antagonist of the Wnt/beta-catenin signaling pathway and has been found to be upregulated in many cancer types. The functional role of DKK1 in cancer progression has been revealed in several studies but there is controversy with regard to Its antitumor function; its oncogenic role seems to be context-dependent. Nevertheless, DKK1 has been proposed to be a potential new biomarker in several types of cancers. The paper by Shen et al. revealed the diagnostic accuracy of DKK1 as a serum biomarker for HOC in a large-scale, multicenter study. Their study demonstrated that serum DKK1 was high in both sensitivity and specificity in diagnosing HOC, especially early-stage HOC and alpha-fetoprotein-negative HCCs. The authors also demonstrated that combination of serum alpha-fetoprotein with serum DKK1 could further improve the diagnostic accuracy. Overall, their findings revealed the importance and significance of DKK1 in HOC diagnosis.