Evaluation of the Role of Serum Midkine (MK) as A New Non-invasive Diagnostic Biomarker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients

Background: Hepatocellular carcinoma (HCC) is the sixth most prevalent malignancy on a global scale and the second leading cause of cancer-associated mortality in men, following lung cancer. Objective: This study aimed to assess Midkine (MK) diagnostic utility as an HCC biomarker in Egyptian patients. Patients and methods: This prospective cross-sectional study was carried out at Ain Shams University Hospitals over six months, involving 80 Egyptian patients with liver cirrhosis (LC): 40 with HCC and 40 without HCC. Results: TheMK levels showed no significant correlation with age, diabetes mellitus (DM), hypertension (HTN), hemoglobin (HB), white blood cell count (WBC), platelet count, aspartate aminotransferase (AST), albumin, or international normalized ratio (INR). However, there were significant positive interactions between MK and alkaline phosphatase (ALP) levels, as well as advanced Barcelona Clinic Liver Cancer (BCLC) stages B and C. Conversely, MK levels were inversely related to Model for End-Stage Liver Disease (MELD) scores. Additionally, MK displayed 87.5% sensitivity (SEN) and 72.5% specificity (SPE) for detecting early-stage HCC, indicating its potential as a diagnostic HCC serum biomarker. Conclusion: MK may serve as a valuable adjunct to alpha-fetoprotein (AFP) in HCC surveillance programs, particularly for AFP-negative or low-AFP HCC cases. This combination could enhance diagnostic accuracy and early detection in high-risk populations.