Clinical significance of serum DKK-1 in patients with gynecological cancer.

Dickkopf-1 (DKK-1) is a secreted protein involved in embryonic development. Dickkopf-1 is also implicated in osteoporosis, arthritis, and cancer and represents a potential therapeutic target for the treatment of these diseases. Because DKK-1 encodes a secreted protein, we investigated whether the DKK-1 protein is secreted into the sera of patients with gynecological cancer. The levels of DKK-1 protein were assessed by enzyme-linked immunosorbent assay in the sera of 104 patients with gynecological cancer including 36 with ovarian, 40 with cervical, and 28 with endometrial cancers. The serum levels of DKK-1 protein were higher in patients with cervical (314.13 [385.02] pg/mL, P = 0.000) and endometrial (46.95 [21.62] pg/mL, P = 0.000) cancers than in healthy individuals (29.45 [11.86] pg/mL). The serum levels of DKK-1 protein were associated with clinical stage in all patients with gynecological cancer. In patients with cervical cancer, the serum levels of DKK-1 protein were also associated with histological type and lymphatic metastasis. Dickkopf-1 protein detection using enzyme-linked immunosorbent assay as a molecular marker can contribute to the detection and the diagnosis of cervical and endometrial cancers, especially for cervical squamous cell cancer.