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肝脏恶性肿瘤包括原发性肝癌、继发性肝癌、肝母细胞瘤、肝脏淋巴瘤、肝脏血管内皮细胞肉瘤、纤维板层肝细胞癌、肝脏未分化胚胎肉瘤等发生在肝脏的恶性病变。其中原发性肝癌（primary liver cancer，PLC）是临床上最常见的恶性肿瘤之一。PLC 在我国的发病人数占全球的55%，是我国第二个最常见的癌症死亡原因。由于肝脏恶性肿瘤具有隐匿性强、恶性程度高，病情进展快的特点，很多患者就诊时已到疾病中晚期，即使采取多学科综合治疗，预后也很不理想。因此，美国肝病研究学会（AASLD）和卫生部制定的《原发性肝癌诊疗规范（2011 年版）》特别强调了早期筛查和早期监测对提高患者生存时间和生存质量的作用。甲胎蛋白（AFP）联合影像学检查是目前筛查肝脏恶性肿瘤的主要方法,但是AFP 和影像学检查尚缺乏足够的敏感性和特异性，尤其对于早期癌症的诊断而言。DKK-1(dickkopf-1)是近年来由德国科学家新发现的一种分泌型糖蛋白。DKK-1 与肝脏恶性肿瘤，尤其与原发性肝癌的早期诊断和预后判断关系密切，是最值得期待的肿瘤诊断标志物之一。本文谨对DKK-1 的分子生物学特点、在恶性肿瘤中的表达以及与肝脏恶性肿瘤的关系进行综述，探讨其作为肝癌诊断蛋白标志物的研究现状及临床应用前景。

英文摘要:

Liver cancer includes primary liver cancer, secondary liver cancer, hepatoblastoma, hepatic lymphoma, hepatic vascular endothelial cell sarcoma, fibrolamellar hepatocellular carcinoma, undifferentiated embryonic liver sarcoma liver and other malignant lesions in the liver. Thereinto, primary liver cancer (PLC) is one of the most common clinical malignant tumors. The incidence cases of PLC in China account for 55% of the cases worldwide, while it is the second most frequent cause of cancer death in China. Because the malignant liver tumors have the characteristics of strong dormance, high malignancy and faster progression of illness, a lot of patients didn't see the doctor until the disease reached the middle-late stage. Even if multi-disciplinary treatment were adopted, prognosis were not ideal as well. Therefore, American Association for the Study of Liver Diseases (AASLD) and the ministry of health of the primary liver cancer diagnosis and treatment standards (2011 edition) in particular emphasis on the impact of early screening and early detection on improving the survival time and the quality of life for patients. Now alpha fetoprotein(AFP) combining imaging examination is the main method of screening for liver malignant tumors, but AFP and imaging examination are not sufficient for sensitivity and specificity, especially for the diagnosises of early cancers. DKK-1 (dickkopf-1) is a newly discovered secretory glycoprotein by a German scientist in recent years. DKK-1 is close to the liver cancer, especially to the early diagnosis and prognosis of PLC, which is one of the most anticipated tumor diagnostic markers. This article gives a review on DKK-1' s molecular biology characteristics, expression in malignant tumors and the relationship with the liver cancer and discusses the present research and prospect in clinic application of DKK-1 as a protein maker for the diagnosis of liver cancer.

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