THE CLINICAL UTILITY OF MIDKINE IN HEPATOCELLULAR CARCINOMA

Abstract

H epatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Conventional tests of hepatic function can not distinguish HCC from other hepatic masses or from cirrhosis. Accordingly, they contribute little to the diagnosis of the tumor. Diagnosis of HCC depends mainly on the detection of tumor markers in the sera of the HCC patients in addition to other diagnostic modalities such as ultrasound, spiral CT and liver histopathology by biopsy. Serum AFP concentrations have been shown to be the most useful tumor marker with regards to HCC but it may be normal in up to 40% of patients (lack of sensitivity). It may be increased in hepatitis and cirrhotic patients (lack of specificity). The availability of a more sensitive serological marker that distinguishes between HCC and benign hepatic lesions would therefore, be very useful for early and specific diagnosis. Midkine (MK), also known as neurite growth promoting factor 2 (NEGF2), is a basic heparin binding growth factor of low molecular weight. Many studies have suggested that serum and tissue expression of MK reflect biological malignant potential of HCC. Moreover, previous studies reported high serum MK values in patients with HCC suggesting that MK might represent a useful marker for HCC and a complementary diagnostic tool.