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. 2018 Jan 1:17:1533033818765209.
doi: 10.1177/1533033818765209.

The Assessment of Clinical Usage and Prognostic Value of YKL-40 Serum Levels in Patients With Rectal Cancer Without Distant Metastasis

Malgorzata Fuksiewicz  1 , Beata Kotowicz  1 , Andrzej Rutkowski  2 , Joanna Achinger-Kawecka  3   4 , Michal Wagrodzki  5 , Maria M Kowalska  1
Affiliations

The Assessment of Clinical Usage and Prognostic Value of YKL-40 Serum Levels in Patients With Rectal Cancer Without Distant Metastasis

Malgorzata Fuksiewicz et al. Technol Cancer Res Treat. .

Abstract

Background: Colorectal cancer is one of the most common and significant malignancies in the world. YKL-40 (chitinase-3-like protein 1) is involved in cell proliferation, migration, inflammation, and tissue remodeling; and serum levels of YKL-40 are associated with patient outcome in various cancers. The aim of this study was to assess the potential clinical usage of YKL-40 pretreatment serum levels as a prognostic biomarker in rectal cancer.

Methods: Concentrations of YKL-40 and standard tumor marker-Carcinoembryonic antigen (CEA)-were assessed in serum of 83 patients with rectal cancer without distant metastasis, and association with clinicopathological characteristics and disease-free and overall survival was evaluated.

Results: Concentration of YKL-40 was significantly higher in serum of patients with rectal cancer compared to healthy controls ( P = .0001), and YKL-40 levels were able to predict rectal cancer (area under the Receiver Operating Characteristic [ROC] curve = .769) with higher accuracy than CEA (area under the ROC curve = .728) in patients with early stage disease. Increased YKL-40 levels were significantly associated with age ( P = .001); however, no association with other clinicopathological characteristics was observed. Finally, in patients with recurrence, the percentage of cases with increased concentration of YKL-40 was significantly higher than in patients without recurrence ( P = .041), and Kaplan-Meier analysis demonstrated that elevated YKL-40 concentration is a predictor of poor overall survival in patients with rectal cancer.

Conclusion: Pretreatment serum levels of YKL-40 may be a novel prognostic factor of overall and disease-free survival in patients with nonmetastatic colorectal cancer.

Keywords: YKL-40; biomarker; prognostic factor; rectal cancer.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Serum YKL-40 pretreatment levels in control group and in patients with early stage rectal cancer.
Figure 2.
Figure 2.
The area under the ROC curve of YKL-40 assays in patients vs control group.
Figure 3.
Figure 3.
Potential of YKL-40 and CEA serum concentrations to discriminate between patients with rectal cancer with low-grade tumors and healthy individuals based on the area under the curve (AUC). Pairwise nonparametric comparisons of the neighboring AUCs were performed by the Wilcoxon test.
Figure 4.
Figure 4.
Disease-free survival (DFS) and overall survival (OS) of patients with rectal cancer stratified by serum levels of YKL-40.
See this image and copyright information in PMC

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