The value of the assessment of serum and pleural Dikkopf-1 concentrations in the differentiation between malignant and non-malignant pleural effusions

Back groundPleural effusion remains a diagnostic challenge. A number of tumor markers might facilitate the identification of patients with malignancies.ObjectiveTo assess the value of Dikkopf-1 concentrations in both serum and pleural fluid in the differentiation between malignant and non malignant pleural effusions.Methods47 patients with pleural effusions were enrolled in the study. They were classified into two groups: group I: 24 patients with malignant effusions, group II: 23 patients with non malignant effusions. Thoracentesis with biochemical, cytological and bacteriological examination of pleural fluid and determination of Dikkopf-1 level in serum and pleural fluid were done.ResultsSerum and pleural levels of DKK-1 were significantly higher in the malignant group compared with the non-malignant group. At cut off point 3091 pg/ml serum DKK-1 shows 100% sensitivity and 91.3% specificity while at cut off point 4607 pg/ml pleural DKK-1 levels showed 100% sensitivity and 100% specificity. In the non malignant group, serum and pleural levels of DKK-1 were significantly higher in TB patients compared to pneumonia and liver cirrhosis.ConclusionsMalignant effusions are associated with elevated serum and pleural DKK-1 level but it cannot be used as sure marker for the diagnosis of malignancy since it rises in many other conditions.