title: Plasma YKL-40, as a prognostic tumor marker in recurrent ovarian cancer.
abstract: BACKGROUND
  YKL-40, a member of family 18 glycosyl hydrolases, is secreted by cancer cells. The function of YKL-40 in cancer diseases is unknown, but it is a growth factor of connective tissue cells and probably has a role in inflammation and remodeling of the extracellular matrix, a process also involved in metastatic malignant diseases. High serum YKL-40 has been associated with poor prognosis for patients with colorectal and recurrent breast cancer.
  
  
  OBJECTIVE
  The purpose of the present study was to examine the prognostic value of plasma YKL-40 in patients presenting with recurring ovarian cancer.
  
  
  METHODS
  YKL-40 was determined by ELISA in plasma samples from 73 patients with relapse of ovarian cancer shortly before start of second-line chemotherapy. The endpoint used was death because of ovarian cancer.
  
  
  RESULTS
  Plasma YKL-40 was increased in ovarian cancer patients (median 94 micro g/L, range 20-1970 micro g/L) compared with age-matched controls (33 micro g/L, range 20-130 micro g/L) (p < 0.001). Fifty-five per cent of the patients had a plasma YKL-40 level above the upper normal 95th percentile of controls. Patients with high plasma YKL-40 (i.e. > 130 micro g/L or > 160 micro g/L) at the time of relapse had significantly shorter survival than patients with normal levels (respectively p = 0.007 and p = 0.004). Plasma YKL-40 proved to be an independent prognostic factor in a multivariate Cox analysis (YKL-40 > 160 micro g/L; HR = 2.27) (p = 0.006), including serum CA-125 and clinical/histological parameters.
  
  
  CONCLUSIONS
  High plasma YKL-40 is related to short survival in patients with recurrent ovarian cancer.
authors.affiliation: Gynecologic Clinic, The Juliane Marie Center, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Hannah
authors.initials: H
authors.lastname: Dehn
authors.forename: Estrid V S
authors.initials: EV
authors.lastname: Høgdall
authors.forename: Julia S
authors.initials: JS
authors.lastname: Johansen
authors.forename: Morten
authors.initials: M
authors.lastname: Jørgensen
authors.forename: Paul A
authors.initials: PA
authors.lastname: Price
authors.forename: Svend A A
authors.initials: SA
authors.lastname: Engelholm
authors.forename: Claus K
authors.initials: CK
authors.lastname: Høgdall
mesh_terms: D054392:Adipokines; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D037102:Lectins; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D010051:Ovarian Neoplasms / Q000097:blood*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins