Abstract
BackgroundThe different expression level of Dickkopf-1 (DKK-1) in different cancers shows that the function of DKK-1 depends on the histological type of the cancer cells and the tissue microenvironment. To our knowledge, the serum expression level of DKK-1 in breast cancer is little known.MethodsBlood samples from 125 consecutive patients diagnosed with breast cancer and 53 control subjects from March 2008 to August 2013 were investigated. Serum DKK-1 expression levels were measured by enzyme-linked immunosorbent assay (ELISA). The overall survival (OS) and relapse-free survival (RFS) analyzed by log-rank test, and survival curves were plotted according to Kaplan–Meier.ResultsThe mean serum level of DKK-1 in patients with breast cancer was 4.99 ± 1.50 ng/mL, and was significantly higher than that in healthy individuals (1.88 ± 0.81 ng/mL, P < 0.001). DKK-1 level correlated significantly with TNM stage (P = 0.009), tumor grade (P = 0.02), lymph node metastasis (P = 0.001), and expression of HER2 (P = 0.002). The DKK-1 expression level was classified as high or low in relation to the median value, and patients with breast cancer (n = 125) were divided into a high expression group (n = 63) and a low expression group (n = 62). The Kaplan-Meier method for survival analysis showed that the patients with a high serum DKK-1 level had a poorer OS (48.7% vs. 81.3%, p = 0.01) and RFS (24.3% vs. 71.6%, p = 0.003) than those with a low expression level. The multivariate Cox regression analysis indicated that serum DKK-1 level was independent prognostic factors for OS and RFS.ConclusionsSerum DKK-1 level can be used as a noninvasive biomarker for the prognosis of breast cancer.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_161
Highlights
The different expression level of Dickkopf-1 (DKK-1) in different cancers shows that the function of DKK-1 depends on the histological type of the cancer cells and the tissue microenvironment
The expression and roles of DKK-1 are different in various cancers, current studies have reported that overexpression of DKK-1 is found in many malignant tumors, including lung cancer, esophageal carcinomas, cervical cancer, and hepatocellular carcinoma (HCC), indicating a potential oncogenic function of DKK-1 [10,11,12,13]
Blood samples Blood samples from 125 consecutive patients diagnosed with breast cancer who underwent surgery at the Department of Breast and Thyroid Surgery, Weihai Municipal Hospital from March 2008 to August 2013 were investigated. 53 control subjects were randomly selected among individuals receiving health examinations at the Health Examination Center of Weihai Municipal Hospital, any of these subjects who had a history of cancer were excluded from the study
Summary
The different expression level of Dickkopf-1 (DKK-1) in different cancers shows that the function of DKK-1 depends on the histological type of the cancer cells and the tissue microenvironment. The expression and roles of DKK-1 are different in various cancers, current studies have reported that overexpression of DKK-1 is found in many malignant tumors, including lung cancer, esophageal carcinomas, cervical cancer, and hepatocellular carcinoma (HCC), indicating a potential oncogenic function of DKK-1 [10,11,12,13]. The expression of DKK-1 was down-regulated significantly in human colon cancer, gastric cancer and melanoma [14,15,16], suggesting that the function of DKK-1 may be different in different types of cancers. In spite of these studies, there little has been reported on the significance of DKK-1 expression in breast cancer progression and prognosis
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