DKK-1 in Serum as a Clinical and Prognostic Factor in Patients with Cervical Cancer

OBJECTIVES: Dickkopf-1 (DKK-1) is involved in osteoporosis, arthritis, and cancer development and can become a potential therapeutic target of these diseases. The different expression of 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. Because DKK-1 is a secreted protein, we investigated whether it could be found in the serum of patients with cervical cancer. STUDY DESIGN: The expression of DKK-1 was measured by enzyme-linked immunosorbent assay (ELISA) in the serum of 60 healthy women, 60 patients with cervical intraepithelial neoplasia (CIN) and 156 patients with cervical cancer. Detailed treatment information of all 156 patients with cervical cancer and exhaustive follow-up data of 138 patients were collected. RESULTS: The levels of serum DKK-1 were significantly increased in patients with cervical cancer (11.90 [SD, 17.28] μg/mL) compared with healthy women (1.48 [SD, 1.86] μg/mL) and patients with CIN (4.77 [SD, 10.24] μg/mL) (p=0.00, p=0.00). The expression of DKK-1 in serum was correlated with lymphatic metastasis and tumor diameter in cervical carcinoma and associated with the prognosis of patients with cervical cancer. CONCLUSIONS: DKK-1 detection with ELISA as a biological marker can be used for the detection and diagnosis of cervical carcinoma. DKK-1 in serum is a good predictor of poor prognosis in patients with cervical cancer.