Clinical Research Papers:

Serum dickkopf-1 as a clinical and prognostic factor in non-small cell lung cancer patients with bone metastases

Rong Qiao, Runbo Zhong, Qing Chang, Jiajun Teng, Jun Pei, Baohui Han and Tianqing Chu _

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Oncotarget. 2017; 8:79469-79479. https://doi.org/10.18632/oncotarget.18446

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Rong Qiao1,*, Runbo Zhong1,*, Qing Chang2, Jiajun Teng1, Jun Pei1, Baohui Han1 and Tianqing Chu1

1Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, People’s Republic of China

2Shanghai Jiao Tong University School of Medicine, Shanghai 200025, People’s Republic of China

*These authors contributed equally to this work

Correspondence to:

Tianqing Chu, email: [email protected]

Baohui Han, email: [email protected]

Keywords: dickkopf-1, non-small cell lung cancer, bone metastasis, prognosis, stage IV

Received: December 20, 2016     Accepted: May 23, 2017     Published: June 12, 2017


Background: The study was designed to evaluate the association between serum dickkopf-1 (DKK1) and non-small cell lung cancer (NSCLC) bone metastases.

Materials and Methods: Serum DKK1 levels were quantified in 470 NSCLC patients, 140 with osseous metastases, 178 with extraosseous metastases, and 152 with early stage in complete remission. The Receiver Operating Characteristic (ROC) curve enabled us to identify a threshold value to distinguish patients with bone metastases.

Results: Serum DKK1 levels in patients with osseous metastases were significantly higher than in the other 2 groups (P < 0.001). ROC curves showed that the optimum cutoff was 311.8 pg/ml (area under curve 0.791, 95% confidence interval 0.739–0.843, sensitivity 77.1% and specificity 71.4%). Of interest, serum DKK1 correlated with the number of bone lesions (P = 0.042) and associated with the poor survival in NSCLC patients with osseous metastases (P = 0.029).

Conclusions: Our data shows that serum DKK1 can be used for the detection of NSCLC bone metastases. More importantly this is the first report to show that serum DKK1 is a good predictor of poor prognosis in NSCLC patients with bone metastases.

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