The Brain Tumor Center, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Neuro Oncol. 2011 Nov;13(11):1244-51. doi: 10.1093/neuonc/nor117. Epub 2011 Aug 10.
The objective of this study was to evaluate whether longitudinal levels of serum YKL-40 correlate with disease status or survival in adults with gliomas. Patients with histologically confirmed gliomas were eligible for this longitudinal study. Serum samples were collected prospectively and concurrently with MRI scans at multiple time points during the course of the disease. YKL-40 levels determined by ELISA were correlated with radiographic disease status and survival. We performed a multivariate survival analysis including well-known prognostic factors such as age, performance status, and extent of surgical resection. Three hundred and forty-three patients with gliomas (41 low-grade, 105 anaplastic, and 197 glioblastoma) were accrued. Two-year survival from registration was 29% for glioblastomas, 62% for anaplastic gliomas, and 83% for low-grade gliomas. A total of 1740 serum samples were collected, and 95.6% of samples had matching MRI scans. Serum YKL-40 level was significantly lower in patients with no radiographic disease compared with patients with radiographic disease in both the anaplastic glioma (P= .0008) and the glioblastoma (P= .0006) cohorts. Serum levels of YKL-40 in patients with low-grade gliomas were not associated with radiographic disease status. Increases in YKL-40 were independently associated with worse survival in anaplastic gliomas (hazard ratio [HR] = 1.4, P= .01) and glioblastomas (HR = 1.4, P< .0001). Longitudinal increases in serum YKL-40 are associated with increased risk of death in patients with glioblastomas and anaplastic gliomas. YKL-40 is also a putative indicator of disease status in these patients.
本研究旨在评估血清 YKL-40 的纵向水平与成人胶质瘤患者的疾病状态或生存是否相关。本纵向研究纳入了经组织学证实的胶质瘤患者。前瞻性采集血清样本，并在疾病过程中的多个时间点与 MRI 扫描同时进行。通过 ELISA 确定 YKL-40 水平，并与放射性疾病状态和生存相关联。我们进行了多变量生存分析，包括年龄、表现状态和手术切除范围等已知的预后因素。共纳入 343 例胶质瘤患者（41 例低级别、105 例间变性和 197 例胶质母细胞瘤）。胶质母细胞瘤的 2 年生存率为 29%，间变性神经胶质瘤为 62%，低级别神经胶质瘤为 83%。共采集了 1740 份血清样本，其中 95.6%的样本有匹配的 MRI 扫描。与有放射性疾病的患者相比，无放射性疾病的患者血清 YKL-40 水平显著降低，无论是在间变性神经胶质瘤（P=.0008）还是胶质母细胞瘤（P=.0006）队列中均如此。低级别胶质瘤患者的血清 YKL-40 水平与放射性疾病状态无关。YKL-40 水平升高与间变性神经胶质瘤（危险比[HR] = 1.4，P=.01）和胶质母细胞瘤（HR = 1.4，P<.0001）的生存率降低独立相关。血清 YKL-40 的纵向升高与胶质母细胞瘤和间变性神经胶质瘤患者死亡风险增加相关。YKL-40 也是这些患者疾病状态的一个潜在指标。
