Previous reports identified CD147 + or DKK1 + PeCa specimens especially with high IRS at the tumor center12,13 and suppressive neutrophils in the tumor core of head and neck cancer17 as strongly associated with metastases, advanced-stage disease, inferior OS and disease-free survival2,22,23,27–31,37,38 and therapeutic resistance1,2,17,32. The gene discussed is DKK1; the disease is neoplasm.