Aberrant Loss of Dickkopf-3 in Gastric Cancer: Can It Predict Lymph Node Metastasis Preoperatively?

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• 作者：Joong-Min Park ; Mi Kyung Kim ; Kyong-Choun Chi ; Jae Hyung Kim…
• 刊名：World Journal of Surgery
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：39
• 期：4
• 页码：1018-1025
• 全文大小：885 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Cardiac Surgery
  General Surgery
  Thoracic Surgery
  Vascular Surgery
  
• 出版者：Springer New York
• ISSN：1432-2323

文摘

Background Dickkopf-3 (DKK3) may act as a tumor suppressor as it is down-regulated in various types of cancer. This study assessed the DKK3 protein expression in gastric cancer and its potential value as a prognostic marker. Methods DKK3 expression was evaluated by immunohistochemistry in 158 gastric cancer samples from patients who underwent gastrectomy from 2002 to 2008. Clinicopathological parameters and survival data were analyzed. Results Loss of DKK3 expression was found in 64 of 158 (40.5?%) samples, and it was associated with advanced T stage (p?p?UICC TNM stage (p?p?=?0.029), lymphovascular invasion (p?=?0.035), and perineural invasion (p?=?0.032). Patients without DKK3 expression in tumor cells had a significantly worse disease-free and overall survival than those with DKK3 expression (p?p?=?0.001, respectively). TNM stage (p?=?0.028 and p?p?p?=?0.003, respectively) were independent predictors of disease-free and overall survival. Based on the preoperative clinical stage assessed by computed tomography (CT), loss of DKK3 expression was predominantly associated with worse prognosis in patients with clinically node-negative advanced gastric cancer (AGC). The combination of DKK3 expression status and CT increased the accuracy of CT staging for predicting lymph node involvement from 71.5 to 80.0?% in AGC patients. Conclusion Loss of DKK3 protein expression was significantly associated with poor survival in patients with gastric cancer and was strongly correlated with the TNM stage. DKK3 might be a potential biomarker of lymph node involvement that can improve the predictive power of CT.