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

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/mL，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。

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

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.