Liu Yanqiong, Tang Weizhong, Xie Li, Wang Jian, Deng Yan, Peng Qiliu, Zhai Limin, Li Shan, Qin Xue
Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
Tumour Biol. 2014 Apr;35(4):3145-54. doi: 10.1007/s13277-013-1411-x. Epub 2013 Nov 21.
The prognostic significance of dickkopf-1 (DKK1) overexpression in solid tumors remains inconclusive. We performed a meta-analysis to evaluate the impact of DKK1 overexpression in solid tumors on patients' overall survival (OS) and disease-free survival (DFS). The pooled hazard ratio (HR) with 95 % confidence interval (CI) was used to estimate the effects. Thirteen studies were included for meta-analysis; four that evaluated hepatocellular carcinoma (HCC), two each that evaluated ovarian carcinoma, esophageal carcinoma, and lung cancer, and one each that evaluated other cancers, namely gastric cancer, breast cancer, urothelial carcinoma, and colorectal cancer. Twelve studies were evaluable for OS and six for DFS. Our analysis results indicated that DKK1 overexpression predicted poor OS (HR = 1.68, 95% CI 1.36-2.08; P < 0.001) and DFS (HR = 1.65, 95% CI 1.37-1.99; P < 0.001). Subgroup analyses showed that DKK1 overexpression was significantly related with poor OS in HCC patients (HR = 1.65; P < 0.001), ovarian carcinoma patients (HR = 2.63; P = 0.045), and other cancers patients (HR = 1.51; P = 0.021). Further, DKK1 overexpression was significantly related with poor DFS in HCC patients (HR = 1.53; P < 0.001) and other cancers patients (HR = 2.02; P < 0.001). This meta-analysis showed that DKK1 may be a novel prognostic marker in solid tumors in Asian patients; it could potentially help to further stratify patients for clinical treatment. More, well-designed studies from Western countries are needed to confirm this finding.
dickkopf-1（DKK1）在实体瘤中过表达的预后意义仍无定论。我们进行了一项荟萃分析，以评估DKK1在实体瘤中过表达对患者总生存期（OS）和无病生存期（DFS）的影响。采用合并风险比（HR）及95%置信区间（CI）来估计效应。纳入13项研究进行荟萃分析；其中4项评估肝细胞癌（HCC），2项评估卵巢癌，2项评估食管癌，2项评估肺癌，1项评估其他癌症，即胃癌、乳腺癌、尿路上皮癌和结直肠癌。12项研究可用于OS分析，6项可用于DFS分析。我们的分析结果表明，DKK1过表达预示着较差的OS（HR = 1.68，95%CI 1.36 - 2.08；P < 0.001）和DFS（HR = 1.65，95%CI 1.37 - 1.99；P < 0.001）。亚组分析显示，DKK1过表达与HCC患者（HR = 1.65；P < 0.001）、卵巢癌患者（HR = 2.63；P = 0.045）及其他癌症患者（HR = 1.51；P = 0.021）较差的OS显著相关。此外，DKK1过表达与HCC患者（HR = 1.53；P < 0.001）及其他癌症患者（HR = 2.02；P < 0.001）较差的DFS显著相关。这项荟萃分析表明，DKK1可能是亚洲患者实体瘤中的一种新型预后标志物；它可能有助于进一步对患者进行临床治疗分层。此外，还需要西方国家开展更多设计良好的研究来证实这一发现。
