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العنوان
CLIINIICAL SIIGNIIFIICANCE OF SERUM
DIICKKOPF-1 IIN NON SMALL
CELL LUNG CANCER /
المؤلف
Ali,Mai Mohamed.
هيئة الاعداد
باحث / Mai Mohamed Ali
مشرف / Sayeda Abd El-Rahiem Saleh
مشرف / Abeer Ibrahim Abd El - Mageed
مشرف / Hala Abdel Al Ahmed
تاريخ النشر
2016
عدد الصفحات
139p.;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض الدم
تاريخ الإجازة
1/1/2016
مكان الإجازة
جامعة عين شمس - كلية الطب - الباثولوجيا الأكلينيكية و الكيميائية
الفهرس
Only 14 pages are availabe for public view

from 139

from 139

Abstract

Lung cancer represents a major health problem worldwide as it is the most frequent cause of death from cancer among men and is the third leading cause of cancer mortality among women.
Bronchoscopy guided biopsy represents the only applied relatively invasive procedure for the initial diagnosis in smokers with suspected disease. However, this procedure is characterized by its poor sensitivity and it is useful only for central lesions while peripheral lesions are not accessible.
Owing to the difficulty in diagnosing the disease at an early stage, there is an urgent need to the development of novel non-invasive and sensitive biomarkers for early diagnosis, detection, as well as monitoring of lung cancer. Tumor markers that have been studied in lung cancer include carcinoembryonic antigen, cytokeratin−19 fragment and neuron−specific enolase. Although they have all been investigated, they currently lack clinical utility.
Dickkopf-1 (DKK-1) is a 35-KD glycoprotein that contains a signal peptide sequence and two cysteine – rich domains and a secreted protein that functions as a negative regulator of the Wnt signaling which plays a critical role in cancer pathogenesis.
Serum DKK-1 in patients with non small cell lung cancer and its relation to histopathological staging and grading, serum DKK-1 were measured in 30 adult patients with NSCLC, 30 patients with benign lung diseases such as COPD, bronchial asthma, pneumonia and interstitial pulmonary fibrosis. In addition to 25 apparently healthy subjects served as control group.
NSCLC patients were classified according to TNM staging into: 12 patients with locally invasive NSCLC, 7 patients with locally advanced NSCLC and 11 patients with advanced NSCLC. This group was furtherly classified according to histological grading into: 11 patients with well differentiated NSCLC, 6 patients with moderately differentiated NSCLC and 13 patients with poorly differentiated NSCLC.
Our study revealed that serum DKK-1 levels were significantly higher in NSCLC patients when compared to both diseased and healthy control subjects, indicating its ability to predict NSCLC.
As regard the relation between serum DKK-1 and TNM staging, our result raveled a significant difference between serum DKK-1 concentrations in different stages (I, III and IV) of NSCLC. Furthermore, our correlation study revealed a significant positive correlation between DKK-1 and TNM staging.
Our study also revealed a highly significant difference between serum DKK-1 concentrations in different NSCLC grades. Furthermore, our correlation study revealed a significant negative correlation between serum DKK-1 and the grade of differentiation of NSCLC. These findings suggested that higher DKK-1 is associated with worse prognosis.
Assessment of diagnostic performance of serum DKK-1 in our study revealed that the best cut-off for DKK-1 to discriminate lung cancer patients from those with benign lung diseases was ≥2450 pg/mL. This cut-off provided sensitivity and a specificity of 57% and 90% respectively, PPV and NPV of 85% and 68% respectively, diagnostic efficiency of 73% and the AUC is 0.644. Furthermore, the diagnostic performance of serum DKK-1 to discriminate lung cancer patients from those of healthy control was assessed and the best cut-off was ≥1960 pg/mL. This cut-off provided sensitivity and a specificity of 73% and 96% respectively, PPV and NPV of 96% and 75% respectively, diagnostic efficiency of 84% and the AUC is 0.746.