Dickkopf-1 (Dkk1)'s dysregulation has been implicated in the pathogenesis of a variety of
cancers. It is part of the Dkk family of
proteins that includes Dkk2, Dkk3 and Dkk4. This family of secreted
proteins shares similar conserved
cysteine domains and inhibits the Wnt/b-
catenin pathway by causing proteasomal B-
catenin degradation, inducing apoptosis, and preventing cell proliferation. Pancreatic ductal
adenocarcinoma (PDAC) is the 4th leading cause of
cancer mortality in the United States due to the late stage of diagnosis and the limited effectiveness of current
therapy. Dkk1 is found increased in PADC patients' specimens and serum. Dkk1 can be a promising
biomarker specific to PDAC, which has the potential to increase PDAC survival rates through improving early stage detection and monitoring progression compared to current
biomarker gold standards. In addition, recent studies suggest that Dkk1 could be an excellent target for
cancer immunotherapy. Interestingly, Dkk1-CKAP4-PI3K/AKT signal pathway also plays role in
pancreatic cancer cell proliferation. In this review, we present the multiple mechanisms of Dkk1 in PDAC studied thus far and explore its function, regulation, and clinical applications in gynecological
cancers including pancreatic ductal
adenocarcinoma (PDAC), breast, ovarian, cervical, and
endometrial cancer. Further research into Dkk1's mechanism and use as a diagnostic tool, alone or in combination with other
biomarkers, could prove clinically useful for better understanding the pathology of PDAC and improving its early detection and treatment.