Abstract： Objective To explore the value of serum Dickkopf-related protein 1 （DKK1）for the early diagnosis of esophageal cancer， and provide theoretical evidence for the diagnosis and treatment of esophageal cancer. Methods A total of 145 patients who were admitted to the Affiliated Hospital of Jiangnan University between October 2009 and April 2011 were included in this study and divided into four groups. There were 72 patients in the esophageal cancer group （54 males and 18 females with their median age of 60.4 years），13 patients in the precancerosis group （9 males and 4 females with their median age of 58.6 years），30 patients in the benign esophageal lesion group （23 males and 7 females with their median age of 56.4 years），and 30 healthy people in the volunteer group （19 males and 11 females with their median age of 58.6 years）. Serum DKK1 protein concentration was measured by enzyme linked immunosorbent assay （ELISA）. Receiver operating characteristics （ROC） curve was drawn to determine the cutoff level with optimal diagnostic accuracy. Results Serum DKK1 protein levels were significantly higher in the esophageal cancer group and precancerosis group than those in the volunteer group and benign esophageal lesion group ［（37.5±2.8） μg/L， （19.7±2.7） μg/L vs. （5.7±0.8） μg/L， （6.5±0.8） μg/L，t=47.391， P＜0.05］. There was no statistical difference in serum DKK1 protein level between the volunteer group and benign esophageal lesion group ［（6.5±0.8） μg/L vs. （5.7±0.8） μg/L， t=4.215，P=0.374］. When the level of serum DKK1 protein was 13.4 μg/L， the diagnostic sensitivity and specificity of esophageal cancer were 74.1% and 96.7%， respectively. Conclusion Overexpression of serum DKK1 protein could be related to the pathogenesis and progression of esophageal cancer. DKK1 protein may be a potential serologic biomarker for the early diagnosis of esophageal cancer.
Citation：
ZHANG Yongjian,JIN Xiaoyin,LIANG Daying.. The Value of Serum Dickkopf 1 Protein for Early Diagnosis of Esophageal Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(6): 659-662. doi:
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Forget MA， Turcotte S， Beauseigle D， et al. The Wnt pathway regulator DKK1 is preferentially expressed in hormone-resistant breast tumours and in some common Cancer types. Br J Cancer， 2007， 96 （4）：646-653.
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Shen Q， Fan J， Yang XR， et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma：a large-scale， multicentre study. Lancet Oncol， 2012， 13 （8）：817-826.
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张欣， 史若愚， 杨欣荣， 等. Dickkopf-1在肝内胆管细胞癌组织及血清中的表达及其临床意义. 中国临床医学， 2012， 19 （2）：102-104.
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Qian J， Yi Q. DKK1 as a novel target for myeloma immunotherapy. Oncoimmunology， 2012， 1 （5）：756-758.
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Hall CL， Daignault SD， Shah RB， et al. Dickkopf-1 expression increases early in prostate cancer development and decreases during progression from primary tumor to metastasis. Prostate， 2008， 68 （13）：1396-1404.
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Lee HS， Lee HE， Park do J， et al. Clinical significance of serum and tissue Dickkopf-1 levels in patients with gastric Cancer. Clin Chim Acta， 2012， 413 （21-22）：1753-1760.
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Gomceli I， Bostanci EB， Ozer I， et al. A novel screening biomarker in gastric Cancer：serum Dickkopf-1. Hepatogastroenterology， 2012， 59 （117）：1661-1664.
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| 15. |
毛友生， 张德超， 赵小航， 等. 食管癌患者血清CEA， SCC和Cyfra21-1含量检测及临床意义. 中华肿瘤杂志， 2003， 25 （13）：457-460.
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| 16. |
Yamabuki T， Takano A， Hayama S， et al. Dikkopf-1 as a novel serologic and prognostic biomarker for lung and esophageal carcinomas. Cancer Res， 2007， 67 （6）：2517-2525.
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- 1. antagonist DICKKOPF-1gene is a downstream target of β-catenin/TCF and is downstream in hunman colon Cancer. Oncogene， 2005， 24 （12）：1098-1103.
- 2. Jemal A， Bray F， Center MM， et al. Global Cancer statistics. CA Cancer J Clin， 2011， 61 （2）：69-90.
- 3. Herszényi L， Pregun I， Tulassay Z. Diagnosis and recognition of early esophageal neoplasia. Dig Dis， 2009， 27 （1）：24-30.
- 4. Kawano Y， Kypta R. Secreted antagonist of the Wnt signaling pathway. J Cell Sci， 2003， 116 （13）：2627-2634.
- 5. Gonzale-Sancho JM， Aguilera O， Garcia JM， et al. The Wnt.
- 6. Endo Y， Beauchamp E， Woods D， et al. Wnt-3a and dickkopf-1 stimulate neurite outgrowth in ewing tumor cells via a frizzled3- and c-Jun n-terminal kinase-dependent mechanism. Mol Cell Biol， 2008， 28 （7）：2368-2379.
- 7. Wirths O， Waha A， Weggen S， et al. Overexpression of human Dickkopf-1， an antagonist of wingless/WNT signaling， in human hepatoblastomas and Wilms’ tumors. Lab Invest， 2003， 83 （3）：429-434.
- 8. Forget MA， Turcotte S， Beauseigle D， et al. The Wnt pathway regulator DKK1 is preferentially expressed in hormone-resistant breast tumours and in some common Cancer types. Br J Cancer， 2007， 96 （4）：646-653.
- 9. Shen Q， Fan J， Yang XR， et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma：a large-scale， multicentre study. Lancet Oncol， 2012， 13 （8）：817-826.
- 10. 张欣， 史若愚， 杨欣荣， 等. Dickkopf-1在肝内胆管细胞癌组织及血清中的表达及其临床意义. 中国临床医学， 2012， 19 （2）：102-104.
- 11. Qian J， Yi Q. DKK1 as a novel target for myeloma immunotherapy. Oncoimmunology， 2012， 1 （5）：756-758.
- 12. Hall CL， Daignault SD， Shah RB， et al. Dickkopf-1 expression increases early in prostate cancer development and decreases during progression from primary tumor to metastasis. Prostate， 2008， 68 （13）：1396-1404.
- 13. Lee HS， Lee HE， Park do J， et al. Clinical significance of serum and tissue Dickkopf-1 levels in patients with gastric Cancer. Clin Chim Acta， 2012， 413 （21-22）：1753-1760.
- 14. Gomceli I， Bostanci EB， Ozer I， et al. A novel screening biomarker in gastric Cancer：serum Dickkopf-1. Hepatogastroenterology， 2012， 59 （117）：1661-1664.
- 15. 毛友生， 张德超， 赵小航， 等. 食管癌患者血清CEA， SCC和Cyfra21-1含量检测及临床意义. 中华肿瘤杂志， 2003， 25 （13）：457-460.
- 16. Yamabuki T， Takano A， Hayama S， et al. Dikkopf-1 as a novel serologic and prognostic biomarker for lung and esophageal carcinomas. Cancer Res， 2007， 67 （6）：2517-2525.
