Purpose: To investigate the role of Dkk1 as a predictor of response to NACT in BC patients. Methods: This retrospective monocentric study included 145 women who had undergone NACT followed by breast surgery. Dkk1 protein expression was assessed using immunohistochemistry staining in core needle biopsies and mammary carcinoma specimens. Results: Dkk1 levels were lower in treated BC tumours than in untreated tumours. The outcomes of 68 matched pre- and post-therapy tissues showed that Dkk1 levels in mammary carcinoma tissues were significantly predicted by levels in core needle biopsies and that Dkk1 expression was reduced in 83% of cases. Smaller cT stage, positive Her2 expression, and decreased Dkk1-IRS in core needle biopsy tissues were all independent predictors of regression grade (R4), according to Sinn. However, the percentage of Dkk1 expression differences prior to and following NACT had no effect on PFS or OS. Conclusions: In this study, we demonstrated for the first time that Dkk1 could be identified as an independent predictor of NACT response in BC patients, particularly those with TNBC. Further research with a multicentric expanded (pre-/post-therapy) sample set and better-defined populations in terms of molecular subtypes, therapy modality, and long-term follow-up is recommended to obtain more solid evidence.
目的：探讨Dkk1作为乳腺癌患者新辅助化疗反应预测因子的作用。方法：本回顾性单中心研究纳入145例接受新辅助化疗后行乳腺手术的女性患者。通过免疫组化染色检测空心针穿刺活检标本及乳腺癌组织标本中的Dkk1蛋白表达水平。结果：经治疗的乳腺癌肿瘤组织中Dkk1水平低于未治疗肿瘤组织。68组配对治疗前后组织分析显示，乳腺癌组织中的Dkk1水平可通过空心针活检标本水平显著预测，且83%的病例中Dkk1表达降低。根据Sinn分级标准，较小的临床T分期、Her2阳性表达以及空心针活检组织中Dkk1免疫反应评分降低均为肿瘤退缩等级（R4）的独立预测因素。然而，新辅助化疗前后Dkk1表达差异百分比对无进展生存期或总生存期无显著影响。结论：本研究首次证实Dkk1可作为乳腺癌患者新辅助化疗反应的独立预测因子，特别是在三阴性乳腺癌患者中。建议未来采用多中心扩展（治疗前/后）样本集，并在分子亚型、治疗方式和长期随访方面明确定义研究人群，以获取更确凿的证据。
Dkk1 as a Prognostic Marker for Neoadjuvant Chemotherapy Response in Breast Cancer Patients
肿瘤(癌症)患者之家