Prognostic and diagnostic effects of high serum midkine levels in patients with hepatocellular carcinoma

Area of Science:

• Oncology
• Biochemistry
• Clinical Diagnostics

Background:

• Midkine (MK) is a cytokine whose serum levels correlate with tumor protein expression.
• Hepatocellular carcinoma (HCC) is a major global health concern.
• Understanding biomarkers for HCC diagnosis and prognosis is crucial.

Purpose of the Study:

• To investigate the clinicopathological and prognostic significance of serum midkine (s-MK) in HCC patients.
• To evaluate s-MK as a potential diagnostic and prognostic biomarker for HCC.

Main Methods:

• Serum samples were collected from 123 HCC patients undergoing surgery.
• Serum MK (s-MK) levels were measured and compared between HCC patients and healthy controls.
• Receiver operating characteristic (ROC) curve analysis determined the optimal cut-off value for s-MK (426 pg/ml).
• Clinicopathological variables and overall survival were analyzed in relation to s-MK status.

Main Results:

• s-MK demonstrated high sensitivity (82.1%), specificity (97.4%), and accuracy (88.0%) in differentiating HCC.
• s-MK positivity was significantly associated with a higher number of tumors (≥2).
• The positivity rate of s-MK was higher than that of alpha-fetoprotein (AFP) and protein induced by vitamin K absence-II (PIVKA-II).
• Patients with s-MK-positive status exhibited significantly worse overall survival.
• Multivariate analysis confirmed s-MK positivity as an independent predictor of poor prognosis.

Conclusions:

• Serum midkine (s-MK) is a promising biomarker for early HCC detection.
• Elevated s-MK levels are associated with advanced disease characteristics, specifically a higher tumor burden.
• s-MK positivity serves as an independent risk factor for poor prognosis in hepatocellular carcinoma patients.