Assessing the Diagnostic Value of Serum Dickkopf-related Protein 1 Levels in Cancer Detection: a Case-control Study and Meta-analysis

Background: This study aimed to summarize the potential diagnostic value of serum DKK1 levels in cancerdetection. Materials and
Methods: Serum DKK1 was measured using enzyme-linked immunosorbent assayin a case-control study. Then we performed a meta-analysis and the pooled sensitivity, specificity, diagnosticodds ratio, and summary receiver operating characteristic (sROC) curves were used to evaluate the overalltest performance.
Results: Serum DKK1 levels were found to be significantly upregulated in gastric cancer ascompared to controls. ROC curve analysis revealed an AUC of 0.636, indicating the test has the potential todiagnose cancer with poor accuracy. The summary estimates of the pooled sensitivity, specificity and diagnosticodds ratio in meta-analysis were 0.55 with a 95% confidence interval (CI) (0.53-0.57), 0.86 (95%CI, 0.84-0.88)and 12.25 (95%CI, 5.31-28.28), respectively. The area under the sROC was 0.85. Subgroup analysis revealedthat the diagnostic accuracy of serum DKK1 in lung cancer (sensitivity: 0.69 with 95%CI, 0.66-0.74; specificity:0.95 with 95%CI, 0.92-0.97; diagnostic odds ratio: 44.93 with 95%CI, 26.19-77.08) was significantly higher thanfor any other cancer.
Conclusions: Serum DKK1 might be useful as a noninvasive method for confirmation ofcancer diagnosis, particularly in the case of lung cancer.