The Value of Serum MidKine as a Marker of Hepatocellular Carcinoma on Top of Hepatitis C Virus Related Cirrhosis

Abstract

Background: Hepatocellular carcinoma (HCC) is characterized by the deficiency of specific symptoms in the early stages of the disease and a poor prognosis. Biomarkers that have the diagnostic ability to distinguish between inflammation, cirrhosis, and HCC are needed for early case detection. MidKine (MK) is overexpressed in many malignancies, including hepatocellular carcinoma, gastric carcinoma, colon carcinoma, lung carcinoma, urinary bladder carcinoma and prostate carcinoma. Objective: The objective is to evaluate serum MidKine as a marker of HCC in HCV-related liver cirrhosis. Patients and Methods: This study included 50 patients with HCC (on top of hepatitis C virus-related cirrhosis), 20 cirrhotic patients due to chronic HCV infection, and 10 normal subjects as a control group. History, examination, and laboratory investigations were performed on all subjects in the three groups including MK and Alpha fetoprotein (AFP) serum levels. Results: Serum levels of AFP and MK were higher in the HCC group than in the other study groups (P < 0.001). AFP was positive in 35 (70%) and negative in 15 (30%) whereas MK was positive in all HCC cases. There was a statistically significant correlation between MK serum levels and AFP serum levels, tumor size, and tumor stage. Conclusion: MidKine is a novel sensitive biomarker that could be used for early detection of HCC and has a high significance in differentiation between cirrhosis and HCC cases. MidKine levels are correlated with HCC stages and sizes.