Chen Hai-Tao, Zheng Jian-Ming, Zhang Yong-Zhen, Yang Ming, Wang Yu-Ling, Man Xiao-Hua, Chen Yan, Cai Quan-Cai, Li Zhao-Shen
From the *Department of Gastroenterology, Changhai Hospital, †Center for Clinical Epidemiology and Evidence-based Medicine, and Departments of ‡Geriatrics, and §Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Pancreas. 2017 Mar;46(3):323-334. doi: 10.1097/MPA.0000000000000751.
The aim of this study was to determine the prognostic value of YKL-40 expression in patients undergoing curative resection of pancreatic cancer.
This cohort study included 234 consecutive patients with pancreatic ductal adenocarcinoma who underwent curative resection. Surgical specimens were immunohistochemically assessed for YKL-40 expression. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of YKL-40 expression. A multivariate logistic regression model was performed to examine the correlation between YKL-40 expression and tumor stage.
Of the 234 patients, YKL-40 overexpression was detected in 149 (63.7%) patients. Survival curves showed that patients with YKL-40 overexpression had significantly shorter survival time than those with low YKL-40 expression (P < 0.001). Cox regression analysis indicated that YKL-40 expression was an independent prognostic factor for both overall survival (hazard ratio, 3.82; 95% confidence interval [CI], 2.38-6.13) and progression-free survival (hazard ratio, 3.73; 95% CI, 2.33-5.99). Multivariate logistic regression analysis demonstrated that YKL-40 overexpression was an independent predictor for advanced tumor stage (odds ratio 4.15; 95% CI, 1.35-12.71).
YKL-40 overexpression predicts poor prognosis and advanced tumor stage in patients undergoing curative resection of pancreatic cancer. Application of adjuvant treatment targeting the YKL-40 pathway may improve prognosis.
本研究旨在确定YKL-40表达在接受胰腺癌根治性切除术患者中的预后价值。
这项队列研究纳入了234例连续接受胰腺癌根治性切除术的导管腺癌患者。手术标本经免疫组织化学评估YKL-40表达情况。采用Kaplan-Meier法和Cox回归分析评估YKL-40表达对预后的影响。进行多因素逻辑回归模型分析以检验YKL-40表达与肿瘤分期之间的相关性。
在234例患者中，149例（63.7%）检测到YKL-40过表达。生存曲线显示，YKL-40过表达患者的生存时间明显短于YKL-40低表达患者（P<0.001）。Cox回归分析表明，YKL-40表达是总生存期（风险比，3.82；95%置信区间[CI]，2.38-6.13）和无进展生存期（风险比，3.73；95%CI，2.33-5.99）的独立预后因素。多因素逻辑回归分析表明，YKL-40过表达是晚期肿瘤分期的独立预测因素（优势比4.15；95%CI，1.35-12.71）。
YKL-40过表达预示着接受胰腺癌根治性切除术患者的预后不良和肿瘤分期较晚。应用针对YKL-40通路的辅助治疗可能改善预后。
