DKK1在食管胃结合部腺癌患者血清中的水平及其临床诊断价值

Serum level and clinical diagnostic value of DKK1 in adenocarcinoma at the esophago-gastric junction

目的:探讨Dickkopf-1(DKK1)在食管胃结合部腺癌患者血清中的表达情况及其诊断意义。方法:采用酶联免疫吸附实验(ELISA)检测79例食管胃结合部腺癌和101例正常对照者血清DKK1的表达水平,采用受试者工作特征曲线(ROC)评价其诊断效能。结果:食管胃结合部腺癌患者血清中的DKK1表达水平明显高于正常对照者,差异有统计学意义(P=0.001)。ROC曲线结果显示,DKK1最佳诊断临界值为2 615.9 pg/m L,曲线下面积(AUC)为0.650(95%CI:0.569~0.731),敏感度为34.2%,特异度为96.0%。DKK1诊断早期患者AUC为0.674(95%CI:0.521-0.827),敏感度为35.7%,特异度为96.0%。DKK1的阳性表达率与食管胃结合部腺癌的性别、年龄、肿瘤大小、浸润深度、淋巴结转移和总TNM分期之间均无明显相关性(P>0.05),但和远处转移明显相关(P<0.05)。结论:DKK1在食管胃结合部腺癌患者血清中高表达,可能是食管胃结合部腺癌一种潜在的早期诊断标志物。

OBJECTIVE：To study the serum level and diagnostic value of Dickkopf-1（DKK1） in patients with adenocarcinoma at the esophago-gastric junction （AEGJ）. METHODS：Serum levels of DKK1 in 79 patients with AEGJ and 101 normal controls were measured by enzyme-linked immunosorbent assay （ELISA）. Receiver operating characteristics （ROC） was used to calculate its diagnostic value.RESULTS：The serum levels of DKK1 were significantly higher in AEGJ than in normal controls （P=0.001）. ROC curves showed that the optimum diagnostic cutoff for serum DKK1 was 2615.9 pg/mL,providing an area under the curve （AUC） of 0.650 （95%CI：0.569-0.731）,a sensitivity/specificity of 34.2%/95.0%. Moreover,serum DKK1 had early diagnostic value for AEGJ [AUC 0.674 （95%CI：0.521-0.827）],35.7% sensitivity and 96.0% specificity. Moreover,the positive rate of DKK1 was not significantly related to age,gender,size of tumor,depth of tumor invasion,lymph node status,or TNM stage （P〉0.05）,but related to distant metastasis （P〈0.05）.CONCLUSION：Serum levels of DKK1 was high in AEGJ patients which indicates that serum DKK1 may be a potential biomarker for early diagnosis of AEGJ.