Abstract
BackgroundDickoppf-1 (DKK-1) is a negative regulator of bone formation with tumorigenic potential. The up-regulation of DKK-1 is an early event in prostate cancer (PCa) development, thus we investigated its role as a marker in the diagnosis and prognosis of PCa.MethodsWe retrospectively enrolled 159 patients who underwent prostate biopsy, either for elevated PSA or suspect digital rectal examination, between 2003 and 2010. During the biopsy, one serum sample was collected from all patients; PSA and DKK-1 were measured by ELISA technique. Amongst the biopsy of 159 patients 75 were affected by PCa and 84 were not the mean period of follow-up for these patients was 5 years; a new biopsy was performed in case of PCa suspicion.ResultsPSA performed better than DKK-1 in detecting PCa (0.63 vs 0.51 respectively). Differently from PSA DKK-1 was significantly higher in patients who developed PCa during follow-up than in cancer-free ones, thus DKK-1 performed better than PSA in detecting these patients (0.67 vs 0.55). DKK-1 was significantly lower in patients with bone metastases, whereas PSA was not significantly different in patients with different outcomes.ConclusionsDKK-1 might be predictive for patients negative at first biopsy who will develop PCa and in the prognosis of bone metastases. It performed worse than PSA in the early diagnosis of Pca.
Highlights
Dickoppf-1 (DKK-1) is a negative regulator of bone formation with tumorigenic potential
DKK-1 and Prostate-specific antigen (PSA) in prostate cancer (PCa) diagnosis PCa patients (75) and controls (84) were comparable for age and DKK-1 serum levels, whereas PSA was significantly lower in non-cancer patients (Figure 2A, B)
In order to evaluate whether PSA performed better than DKK-1 we carried out a Receiver Operating Characteristic (ROC) analysis, the PSA area under ROC curves (AUROCs) was slightly, non-significantly, better that DKK-1 AUROC (Figure 2C)
Summary
Dickoppf-1 (DKK-1) is a negative regulator of bone formation with tumorigenic potential. The up-regulation of DKK-1 is an early event in prostate cancer (PCa) development, we investigated its role as a marker in the diagnosis and prognosis of PCa. Prostate-specific antigen (PSA) is the most famous and debated cancer marker in the urological field. PCa is currently the most frequently diagnosed cancer in males and constitutes a major health issue in developed countries, but the majority of PCa cases are considered clinically not significant and certainly not lethal. These discrepancies highlight the need for the early detection of PCa, especially for cases with aggressive features, which require an early and radical intervention.
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