Meta-analysis Of Blood DKK-1 In The Diagnosis Of Primary Liver Cancer

Objective: The value of serum DKK-1 in the diagnosis of primary liver cancer was systematically evaluated by collecting the previously published qualified literatures on the diagnosis of primary liver cancer with serum DKK-1.Methods : The literatures published in Pub Med,Web of Science,Embase,CNKI,Wanfang,VIP and China Biomedical Database from the establishment of the database to December 2021 were searched in Chinese or English system.The literatures related to DKK-1 diagnosis of primary liver cancer were collected and the information statistics and quality classification were conducted.Statistical indicators such as true positive rate(TP),false positive rate(FP),false negative rate(FN),true negative rate(TN),sensitivity(SEN)and specificity(SPE)were extracted for meta analysis using STATA16 software.Combined sensitivity(SEN),combined specificity(SPE),positive and negative likelihood ratio(PLR and NLR),diagnostic odds ratio(DOR)and receiver operating characteristics(SROC)curves were calculated to systematically evaluate the diagnostic value of serum DKK-1 in detecting primary liver cancer.Results: A total of 38 literatures were included,including 26 Chinese literatures and 12 English literatures.The sample size was 10061 cases,including 3971 cases in the liver cancer group and 6090 cases in the control group.Heterogeneity test indicated that heterogeneity was large.The sensitivity(Sen)=0.76,95%CI[0.71,0.80],the specificity(Spe)=0.90,95%CI [0.87,0.93],positive likelihood ratio(PLR)=7.6,95%CI [5.0,10.0],Negative likelihood ratio(NLR)=0.27,95%CI[0.23,0.33],area under the SROC curve of combined effect size(AUC)=0.90,95%CI [0.87,0.,93].Conclusions: Serum DKK-1 can be used as a serologic marker for primary liver cancer with high sensitivity,specificity and accuracy.