Objective: To study the association between the level of serum DKK1 and disease course of multiple myeloma（MM）as well as myeloma bone disease.
Methods: This study enrolled 145 cases of MM（including 79 newly diagnosed MM, 19 responded MM, 47 relapsed or progressive MM） whose lytic bone disease were evaluated by conventional radiography, ELISA was used to detect the concentration of serum DKK1.
Results: Serum DKK-1 elevated in newly diagnosed MM compared with normal donors［2 155（646-35 251）vs 1 487（646-2 577） ng/L, P=0.000］, those responded［1 136（431- 3 582） ng/L, P=0.001］and relapsed/progressive MM［1 695（431-3 582） ng/L, P=0.037］, and the level of relapsed/progressive MM was marginally higher than the responded ones. Moreover, MM patients without lytic lesions in conventional radiography had significantly lower DKK- 1 levels than those with lytic bone disease［1 910（660-26 925）vs 2 519（646-35 251） ng/L, P=0.005］. Notably serum DKK-1 correlated with the number of bone lesions［0 vs 1-3 vs >3 lesions: 1 910（660-26 925）vs 2 155（1 369-5 974）vs 2 547（646-35 251）ng/L, P=0.018].
Conclusion: DKK-1 serum concentration correlated with disease course of MM and myeloma bone disease, indicating that DKK-1 was an important factor for the extent of bone disease, which supporting the hypothesis of DKK-1 as a therapeutic target in myeloma bone disease.
目的: 探讨血清DKK1水平与多发性骨髓瘤(MM)患者病程及MM骨病的关系。
方法: 纳入2010–2014年诊治的145例MM患者及43名正常对照者，通过全身骨骼X线检查确定骨病情况，ELISA法检测血清dickkopf1 (DKK1)蛋白表达水平。
结果: 145例患者中初治者79例，缓解者19例，复发进展者47例。初治组DKK1水平为2 155(646~35 251) ng/L，明显高于正常对照组[1487(646~2 577) ng/L，P=0.000]、缓解组[1 136(431~3 582) ng/L，P=0.001]及复发进展组[1 695(431~3 582)ng/L，P=0.037]，差异均有统计学意义。复发进展组患者DKK1表达稍高于缓解患者，但差异无统计学意义(P=0.078)。合并骨病者的血清DKK1水平[2 519(646~35 251)ng/L]显著高于无骨病者[1 910(660~26 925)ng/L]，差异有统计学意义(P=0.005)，溶骨性病变部位0、1~3、>3处患者血清DKK1水平分别为1 910(660~26 925)、2 155(1 369~5 974)、2 547 (646~35 251)ng/L，差异有统计学意义(P=0.018)。
结论: MM患者血清DKK1表达水平不仅与MM疾病状态相关，且与溶骨性病变及其数目相关，为临床进行DKK1靶向治疗MM提供了理论依据。