Yamac Deniz, Ozturk Banu, Coskun Ugur, Tekin Ercument, Sancak Banu, Yildiz Ramazan, Atalay Can
Department of Medical Oncology, Gazi University Medical School, Ankara, Turkey.
Adv Ther. 2008 Aug;25(8):801-9. doi: 10.1007/s12325-008-0082-2.
YKL-40 is a growth factor for connective tissue cells; it also stimulates the migration of endothelial cells. YKL-40 is secreted by cancer cells, and elevated serum levels have been associated with poorer prognosis in metastatic breast cancer. In the present study we evaluated the prognostic role of serum YKL-40 levels in patients with locally advanced breast cancer.
YKL-40 levels were measured using ELISA in serum samples obtained from 45 breast cancer patients prior to surgery and chemotherapy. The median follow-up time was 46 months (range, 10-96 months). All patients underwent surgery after chemotherapy. During the follow-up period, 21 patients relapsed and there were 17 deaths.
The median serum YKL-40 concentration in patients with locally advanced breast cancer was 149.5 mug/l (range, 25.0-1021.3 microg/l). This was higher than levels observed in healthy female controls but the difference was not significant (P=0.44). Serum YKL-40 levels were also higher in patients with tumour size >2 cm and node-positive disease but again the differences were not significant (P>0.05). Tumour volume was correlated with serum YKL-40 levels (r=0.308, P=0.039). High serum YKL-40 levels were associated with shorter disease-free and overall survival although this trend failed to reach significance (P>0.05). Multivariate analysis including tumour size, lymph node status, oestrogen and progesterone receptor status, tumour grade, and serum YKL-40 levels indicated that serum YKL-40 levels were an independent prognostic variable for overall survival (hazard ratio, 1.004; 95% confidence intervals: 1.00, 1.07; P=0.027). Tumour size, lymph node status and oestrogen receptor status were also independent prognostic variables for overall survival (P<0.05).
Our results show that serum levels of the growth factor YKL-40 may be a useful prognostic indicator of outcome for patients with locally advanced breast cancer. Further studies are required to fully elucidate the biological function of YKL-40 in breast cancer.
YKL-40是一种结缔组织细胞生长因子；它还能刺激内皮细胞迁移。YKL-40由癌细胞分泌，血清水平升高与转移性乳腺癌较差的预后相关。在本研究中，我们评估了血清YKL-40水平在局部晚期乳腺癌患者中的预后作用。
使用酶联免疫吸附测定法（ELISA）测量45例乳腺癌患者手术和化疗前血清样本中的YKL-40水平。中位随访时间为46个月（范围10 - 96个月）。所有患者化疗后均接受手术。随访期间，21例患者复发，17例死亡。
局部晚期乳腺癌患者血清YKL-40浓度中位数为149.5微克/升（范围25.0 - 1021.3微克/升）。这高于健康女性对照组的水平，但差异不显著（P = 0.44）。肿瘤大小>2厘米和淋巴结阳性疾病患者的血清YKL-40水平也较高，但差异同样不显著（P>0.05）。肿瘤体积与血清YKL-40水平相关（r = 0.308，P = 0.039）。血清YKL-40水平高与无病生存期和总生存期较短相关，尽管这一趋势未达到显著水平（P>0.05）。多因素分析包括肿瘤大小、淋巴结状态、雌激素和孕激素受体状态、肿瘤分级以及血清YKL-40水平，结果表明血清YKL-40水平是总生存期的独立预后变量（风险比，1.004；95%置信区间：1.00，1.07；P = 0.027）。肿瘤大小、淋巴结状态和雌激素受体状态也是总生存期的独立预后变量（P<0.05）。
我们的结果表明，生长因子YKL-40的血清水平可能是局部晚期乳腺癌患者预后的有用指标。需要进一步研究以充分阐明YKL-40在乳腺癌中的生物学功能。
