Serum YKL-40: a new potential marker of prognosis and location of metastases of patients with recurrent breast cancer.
YKL-40 is a recently discovered glycoprotein which is related in amino acid sequence to the chitinase protein family, but has no chitinase activity. Although the function of YKL-40 is presently unknown, the pattern of its expression by some tissues suggests that YKL-40 could function in tissue remodelling. The diagnostic features and relation to survival of serum YKL-40 have not been examined previously in human malignancies. In the present study YKL-40 was measured in serum obtained from 60 patients at the time that breast cancer recurrence was suspected. The median serum YKL-40 in patients with visceral or bone metastases was 328 and 157 micrograms/l, respectively and significantly higher compared to controls (99 micrograms/l, P < 0.001). Kaplan-Meier survival curves demonstrated that survival rates after 18 months were 24% for patients with high serum YKL-40 (> 207 micrograms/l = the 95 percentile of controls) and 60% for patients with normal serum YKL-40. The significance of the difference between the shorter survival of patients with high serum YKL-40 and the longer survival of patients with normal serum YKL-40 was high (P < 0.0009). When evaluated with other prognostic factors of survival after recurrence of breast cancer, serum YKL-40 and serum lactate dehydrogenase (LDH) were the most significant independent factors. The results indicate that determination of serum YKL-40 can be used as a prognostic marker related to the extent of disease and survival of patients with recurrence of breast cancer. In addition, the serum YKL-40 level may be of value in the follow-up of patients with breast cancer and in evaluating potential metastatic spread.
Johansen
J S
JS
Department of Medicine, University of Copenhagen, Hvidovre Hospital, Denmark.
Cintin
C
C
Jørgensen
M
M
Kamby
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C
Price
P A
PA
D054392:Adipokines; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood / Q000556:secondary; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006023:Glycoproteins; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D037102:Lectins; D008113:Liver Neoplasms / Q000097:blood / Q000378:metabolism; D008875:Middle Aged; D011379:Prognosis; D011506:Proteins / Q000032:analysis*; D012044:Regression Analysis; D012142:Respiratory Tract Neoplasms / Q000097:blood / Q000378:metabolism; D012983:Soft Tissue Neoplasms / Q000097:blood / Q000556:secondary; D016019:Survival Analysis
D054392:Adipokines; D014408:Biomarkers, Tumor; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins; D011506:Proteins; D007770:L-Lactate Dehydrogenase