Supplementary Table 2. Diagnostic Accuracy of DKK-1, AFP, and DCP in Diagnosing Early-Stage HCC.
| AUC | 95% CI | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | +LR | -LR | |
|---|---|---|---|---|---|---|---|---|
| Early-stage HCC (TNM I-II) vs. all controls | ||||||||
| DKK-1 | 0.818 | 0.768-0.868 | 89.0 | 62.9 | 69.7 | 85.6 | 2.40 | 0.18 |
| AFP | 0.772 | 0.714-0.830 | 61.8 | 89.5 | 84.8 | 71.4 | 5.91 | 0.43 |
| DCP | 0.777 | 0.721-0.833 | 59.2 | 93.5 | 90.3 | 69.1 | 9.14 | 0.44 |
| DKK-1 plus AFP | 0.893 | 0.857-0.928 | 86.2 | 76.2 | 77.6 | 85.2 | 3.62 | 0.18 |
| DKK-1 plus DCP | 0.908 | 0.876-0.941 | 76.2 | 90.5 | 89.3 | 78.5 | 8.03 | 0.26 |
| DKK-1 plus AFP plus DCP | 0.939 | 0.913-0.964 | 84.6 | 90.5 | 90.3 | 84.9 | 8.92 | 0.17 |
| Early-stage HCC (BCLC A-B) vs. all controls | ||||||||
| DKK-1 | 0.811 | 0.760-0.862 | 85.0 | 62.9 | 69.1 | 81.2 | 2.29 | 0.24 |
| AFP | 0.772 | 0.714-0.830 | 61.6 | 89.5 | 84.9 | 71.0 | 5.89 | 0.43 |
| DCP | 0.783 | 0.728-0.838 | 60.4 | 93.5 | 90.6 | 69.5 | 9.33 | 0.42 |
| DKK-1 plus AFP | 0.891 | 0.855-0.927 | 83.7 | 76.2 | 77.4 | 82.7 | 3.51 | 0.21 |
| DKK-1 plus DCP | 0.910 | 0.878-0.942 | 75.9 | 90.5 | 89.4 | 78.0 | 7.99 | 0.27 |
| DKK-1 plus AFP plus DCP | 0.940 | 0.915-0.965 | 84.1 | 90.5 | 90.4 | 84.4 | 8.87 | 0.18 |
| Early-stage HCC (TNM I-II) vs. all controls except healthy subjects | ||||||||
| DKK-1 | 0.818 | 0.768-0.868 | 89.0 | 63.1 | 75.9 | 81.4 | 2.41 | 0.17 |
| AFP | 0.772 | 0.714-0.830 | 61.4 | 85.8 | 84.8 | 63.4 | 4.33 | 0.45 |
| DCP | 0.777 | 0.721-0.833 | 59.2 | 91.9 | 91.3 | 61.1 | 7.32 | 0.44 |
| DKK-1 plus AFP | 0.893 | 0.857-0.928 | 85.5 | 75.7 | 82.1 | 80.0 | 3.52 | 0.19 |
| DKK-1 plus DCP | 0.908 | 0.876-0.941 | 76.2 | 8.7 | 90.8 | 71.7 | 6.72 | 0.27 |
| DKK-1 plus AFP plus DCP | 0.939 | 0.913-0.964 | 84.6 | 88.7 | 91.7 | 79.6 | 7.46 | 0.17 |
| Early-stage HCC by (BCLC A-B) vs. all controls except healthy subjects | ||||||||
| DKK-1 | 0.811 | 0.760-0.862 | 85.0 | 63.1 | 75.3 | 76.1 | 2.30 | 0.24 |
| AFP | 0.772 | 0.714-0.830 | 61.6 | 85.8 | 84.9 | 63.4 | 4.35 | 0.45 |
| DCP | 0.783 | 0.728-0.838 | 60.4 | 91.9 | 91.6 | 61.5 | 7.48 | 0.43 |
| DKK-1 plus AFP | 0.891 | 0.855-0.927 | 83.0 | 75.7 | 81.9 | 77.1 | 6.41 | 0.22 |
| DKK-1 plus DCP | 0.910 | 0.878-0.942 | 75.9 | 88.7 | 90.9 | 71.1 | 6.69 | 0.27 |
| DKK-1 plus AFP plus DCP | 0.940 | 0.915-0.965 | 84.1 | 88.7 | 91.7 | 78.9 | 7.42 | 0.18 |
DKK-1, dickkopf-1; HCC, hepatocellular carcinoma; AFP, alpha-fetoprotein; DCP, des-gamma-carboxy prothrombin; AUC, area under receiver operating characteristic curve; CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; LR, likelihood ratio; TNM, Tumor-Node-Metastasis; BCLC, Barcelona Clinic Liver Cancer.
The optimum predicted probabilities of DKK-1, AFP, DCP, and their combination were derived from their respective ROC curves by maximizing the sum of sensitivity and specificity and minimizing the overall error.