Wan Guoxing, Xiang Longchao, Sun Xue, Wang Xuanbin, Li Hongliang, Ge Wei, Cao Fengjun
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, Shiyan 442000, Hubei, China.
Oncotarget. 2017 Jan 17;8(3):5382-5391. doi: 10.18632/oncotarget.14280.
Numerous studies have investigated the prognostic role of YKL-40 in breast cancer, but yielded inconsistent results. To derive a more precise evaluation, relevant publications assessing the association between YKL-40 expression and clinical outcome of breast cancer patients were electronically searched and identified. A combined analysis of included studies was performed using fixed- or random-effect model to calculate the pooled hazard ratio (HR) or odds ratio(OR) and 95% confidence interval (95%CI) for the assessment of the association. Ten eligible studies involving 1250 patients were ultimately included in the meta-analysis. Overall, the pooled analysis showed that elevated YKL-40 expression was significantly associated with a poor overall survival(OS: HR=1.48, 95%CI= 1.11-1.97) and disease-free survival(DFS: HR=1.51, 95%CI= 1.10-2.07). The subgroup analysis by detection methods revealed an unfavorable OS in breast cancer patients with elevated YKL-40 expression evaluated by IHC(HR=1.39, 95%CI=1.12-1.71) but not by ELISA/RIA. Also, the stratification analysis by ethnicity showed a significant association between increased YKL-40 expression and shorter OS of breast cancer patients in western population(HR=1.51, 95%CI=1.03-2.21) as well as Asian population (HR=1.40, 95%CI= 1.05-1.86). Similarly, the subgroup analysis by detection methods revealed a significantly inferior DFS in breast cancer patients with increased YKL-40 expression disregarding the use of IHC(HR=2.02, 95%CI=1.47-2.79) or ELISA/RIA(HR=1.06, 95%CI= 1.02 -1.10). Additionally, increased YKL-40 expression was found to significantly correlate with larger tumor size (OR=2.38, 95%CI=1.41-4.05).The present meta-analysis indicate that elevated YKL-40 expression is associated with a poor prognosis in breast cancer patients. YKL-40 may serve as a promising predictive biomarker of prognosis of breast cancer.
众多研究探讨了YKL-40在乳腺癌中的预后作用，但结果并不一致。为了得出更精确的评估，通过电子检索和识别评估YKL-40表达与乳腺癌患者临床结局之间关联的相关出版物。使用固定效应或随机效应模型对纳入研究进行合并分析，以计算合并风险比（HR）或比值比（OR）以及95%置信区间（95%CI），用于评估该关联。最终，10项涉及1250例患者的符合条件的研究被纳入荟萃分析。总体而言，合并分析表明，YKL-40表达升高与总体生存期较差（OS：HR=1.48，95%CI=1.11-1.97）和无病生存期较差（DFS：HR=1.51，95%CI=1.10-2.07）显著相关。按检测方法进行的亚组分析显示，通过免疫组化（IHC）评估YKL-40表达升高的乳腺癌患者总体生存期较差（HR=1.39，95%CI=1.12-1.71），但通过酶联免疫吸附测定/放射免疫分析（ELISA/RIA）评估则不然。此外，按种族进行的分层分析显示，在西方人群（HR=1.51，95%CI=1.03-2.21）以及亚洲人群（HR=1.40，95%CI=1.05-1.86）中，YKL-40表达升高与乳腺癌患者较短的总体生存期显著相关。同样，按检测方法进行的亚组分析显示，无论使用免疫组化（HR=2.02，95%CI=1.47-2.79）还是酶联免疫吸附测定/放射免疫分析（HR=1.06，95%CI=1.02-1.10），YKL-40表达升高的乳腺癌患者无病生存期均显著较差。此外，发现YKL-40表达升高与更大的肿瘤大小显著相关（OR=2.38，95%CI=1.41-4.05）。本荟萃分析表明，YKL-40表达升高与乳腺癌患者预后不良相关。YKL-40可能是一种有前景的乳腺癌预后预测生物标志物。
