| Background:The incidence of breast cancer is increased year by year.For the patients with breast cancer,the cause of death in is mostly by distant metastasis,and much common in bone,lung metastasis.?-catenin signal pathway adjusts and controls a variety of development process as the embryogenesis and neurogenesis.And it plays a crucial role in maintaining the balance of the body's dynamic.As the inhibitor of Wnt/?-catenin Biological molecular signal pathway,Dickkopf-1(DKK1)can decide the cell migration,proliferation and other features by regulating the Wnt/beta-catenin pathway.Objective:Investigating the expression level of serum DKK1 in breast cancer metastasis in bone and lung,studying the diagnostic value of DKK1 for breast cancer and it's metastasis in bone and lung.Analysis of influencing factors of bone and lung metastasis in breast cancer.Providing certain reference frame and condition assessment for the clinical diagnosis of breast cancer metastasis in bone and lung.Methods:Selected 168 cases from the breast cancer patients which received by our hospital from October 2016 to October 2018 as a research object,and the research object were divided into bone metastases group(58 cases)and pulmonary metastasis group(23 cases),without metastasis group(87 cases)according to whether the patients with bone or lung metastases;100 healthy subjects were selected as the control group.Collect the research object of basic data and the clinical and pathological data of breast cancer patients in each group.And use the double antibody sandwich enzyme-linked immunosorbent assay with quantitative methods(ELISA)to measure the serum DKK1 expression level in each group.After statistical analysis of collected data,by the logistic regression analysis to search the influence factors of breast cancer,and discuss the diagnostic value of DKK1 with the ROC Curve.Results:(1)Analysis of clinical data of breast cancer non-metastasis group,lung metastasis group,bone metastasis group and control group showed that there were significant differences between body mass index(BMI),family breast cancer history and menopausal history(P=0.000).(2)Serum DKK1 concentrations were(6.25±2.086)ng/mL,(9.98±2.107)ng/mL,(8.61±2.303)ng/mL,(12.19±2.203)ng/mL in the control group,breast cancer non-metastasis group,lung metastasis group and bone metastasis group,respectively.The serum DKK1 concentration in the bone metastasis group was significantly higher than that in the lung metastasis group(P<0.05),and there was a statistically significant difference between the two groups(P<0.05).(3)Comparing the pathological data of breast cancer non-metastasis group,lung metastasis group and bone metastasis group,it was found that TNM stage,tumor grade,Her-2 expression level were significantly different(P=0.000);There was no significant difference in the expression level of ER,PR and histopathological type(P>0.05).(4)The multi-class logistic regression analysis found that serum DKK1 is a risk factor for bone metastasis in breast cancer(OR=1.798,95% CI: 1.409-2.293),and is not a factor influencing lung metastasis(OR=0.764,95% CI: 0.559-1.043).(5)By the ROC Curve we found the area under the curve(AUC)of the breast cancer bone metastasis diagnosis is 0.788,when the optimal threshold value is11.77ng/ml,it was 60.34% for its sensitivity,83.64% for specificity,43.98% for the Youden index.Conclusion:(1)Serum DKK1 is expressed differently in breast cancer bone metastasis and lung metastasis;(2)The expression level of serum DKK1 is of guiding significance for the clinical diagnosis of bone metastasis of breast cancer. |
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