Fan J T, Li M J, Shen P, Xu H, Li D H, Yan H Q
Eur J Gynaecol Oncol. 2014;35(3):304-8.
Serum YKL-40 level is elevated in patients with several malignancies. This study was designed to assess the correlation between serum YKL-40 and the corresponding tissue expression in endometrial cancer (EC).
Preoperative serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA) from 41 patients with EC, 27 patients with uterine myoma, and 30 healthy women. YKL-40 protein expression in tissue was determined by immunohistochemistry for patients with EC and patients with uterine myoma.
Median preoperative serum YKL-40 level was 157.2 microg/l (range 76.0 - 301.2) in EC compared with 86.6 microg/l (range 69.3 - 191.1) in uterine myoma, and 86.2 microg/l (range 52.1 - 201.1) in healthy women (p < 0.05). Of 41 patients with EC, 26 patients with elevated serum YKL-40 level statistically differed from the remaining 15 patients with normal serum YKL-40 level with respect to FIGO Stage, tumor grade, washing cytology, and serum CA125 (p < 0.05). In multivariate analysis, elevated serum YKL-40 significantly correlated with FIGO stage (p < 0.05) and tumor grade (p < 0.01). The percentage of positive YKL-40 tissue staining was higher in EC patients (34.1%, 14/41) than in uterine myoma patients (11.1%, 3/27) (p < 0.05) and was lower than that of elevated serum levels in EC (26/41, 63.4%) (p < 0.05).
The elevated preoperative serum YKL-40 is related to stage and histologic grade of EC. The discordance between serum and tissue level of YKL-40 in EC indicates intrauterine tumor may not be the only source of serum YKL-40.
多种恶性肿瘤患者血清YKL-40水平升高。本研究旨在评估子宫内膜癌（EC）患者血清YKL-40与相应组织表达之间的相关性。
采用酶联免疫吸附测定（ELISA）法检测41例EC患者、27例子宫肌瘤患者和30例健康女性术前血清YKL-40水平。通过免疫组织化学法检测EC患者和子宫肌瘤患者组织中YKL-40蛋白表达。
EC患者术前血清YKL-40水平中位数为157.2μg/l（范围76.0 - 301.2），子宫肌瘤患者为86.6μg/l（范围69.3 - 191.1），健康女性为86.2μg/l（范围52.1 - 201.1）（p < 0.05）。在41例EC患者中，血清YKL-40水平升高的26例患者在国际妇产科联盟（FIGO）分期、肿瘤分级、冲洗细胞学检查和血清CA125方面与其余15例血清YKL-40水平正常的患者存在统计学差异（p < 0.05）。多因素分析显示，血清YKL-40升高与FIGO分期（p < 0.05）和肿瘤分级（p < 0.01）显著相关。EC患者YKL-40组织染色阳性率（34.1%，14/41）高于子宫肌瘤患者（11.1%，3/27）（p < 0.05），低于EC患者血清水平升高者（26/41，63.4%）（p < 0.05）。
术前血清YKL-40升高与EC的分期和组织学分级有关。EC患者血清和组织中YKL-40水平不一致表明子宫内肿瘤可能不是血清YKL-40的唯一来源。
