分泌蛋白DKK1(Dickkopf-1)在胃癌患者血清及组织中的表达及其意义

Clinical significance of serum and tissue Dickkopf-1 levels in patients with gastric cancer

目的探讨DKK1(Dickkopf-1)在胃癌患者血清及组织中的表达及其意义。方法检测153例胃癌患者与173名健康志愿者血清中DKK1含量。免疫组化检测144例胃癌患者(从153例胃癌患者中选取)和265例回顾性胃癌患者肿瘤组织中DKK1表达情况。结果胃癌组血清DKK1含量明显高于健康人群组(P<0.05)。当把血清DKK1浓度31.9150 pg/mL设为诊断胃癌的阈值时,其诊断特异性和敏感性分别为87.9%和87.6%。血清DKK1浓度大于60.0 pg/mL胃癌患者生存期明显低于血清DKK1浓度较低患者(P=0.033)。胃癌组织中DKK1高表达与血清DKK1含量有密切相关性。结论低浓度阈值的DKK1可以作为胃癌诊断标志物,而高浓度阈值的DKK1可以作为胃癌预后预测标志物。血清和组织中DKK1表达水平可以帮助诊断胃癌,预测胃癌患者预后。

[ Objective ] Dickkopf-1 （DKK1）, a secreted protein known as a negative regulator of the Wnt signal- ing pathway, has been implicated in tumorigenesis. However, the clinical significance of DKK1 in gastric cancer has not been clarified. [Methods] Serum concentrations of DKK1 in 153 patients with gastric cancer and 173 healthy controls were assessed. For tissue DKK1, immunohistochemistry was performed in 144 cancer specimens from 153 patients and in an additional 265 consecutive gastric cancer specimens. [Results] The serum DKK1 concentrations were significantly higher in the gastric cancer patients than in the healthy controls （pb 0.001）. At a cutoff concentra- tion of 31.9150 pg/mL, the sensitivity and the specificity for gastric cancer diagnosis were 87.6% and 87.9%, re- spectively. The gastric cancer patients with a serum DKK1 level of 〉160.0 pg/mL had significantly diminished sur- vival compared with the patients whose serum DKK1 levels were lower（P =0.033）. The DKK1 over-expression in the cancer specimens significantly correlated with the increased serum DKK1 concentrations. [Conclusions] SerumD- KK1 levels have the potential as a diagnostic marker at a low cutoff value and as a prognostic marker at a high cut- off value. Serum and tissue DKK1 levels may aid in diagnosing gastric cancer and predicting patient outcomes.