Serum YKL-40, a new prognostic biomarker in cancer patients?
YKL-40, a member of the "mammalian chitinase-like proteins," is expressed and secreted by several types of solid tumors. The exact function of YKL-40 in cancer diseases is unknown and is an important objective of future studies. YKL-40 exhibits growth factor activity for cells involved in tissue remodeling processes. YKL-40 may have a role in cancer cell proliferation, survival, and invasiveness, in the inflammatory process around the tumor, angiogenesis, and remodeling of the extracellular matrix. YKL-40 is neither organ- nor tumor-specific. However, the present retrospective clinical studies of patients with eight different types of primary or advanced solid tumors suggest that serum concentration of YKL-40 may be a new biomarker in cancer patients used as a "prognosticator." Elevated serum YKL-40 is found in a subgroup of patients with different types of solid tumors, including several types of adenocarcinomas, small cell lung carcinoma, glioblastoma, and melanoma. The highest serum YKL-40 is detected in patients with advanced cancer and with the poorest prognosis. In many cases, serum YKL-40 provides independent information of survival. Serum YKL-40 cannot be used as a single screening test for cancer. The use of serum YKL-40 has not received Food and Drug Administration approval for use as a biomarker for cancer or any other disease. Large multicenter retrospective and prospective studies of patients with different types of cancer are required to determine: (a) if serum YKL-40 is a useful prognostic cancer biomarker, (b) if serum YKL-40 can be of value in monitoring patients with cancer in order to provide information about metastases before these are detected by routine methods, and (c) if serum YKL-40 can be useful for screening of cancer together with a panel of other cancer biomarkers and imaging techniques.
Johansen
Julia S
JS
Department of Rheumatology Q107, Herlev Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark. julia.johansen@post3.tele.dk
Jensen
Benny Vittrup
BV
Roslind
Anne
A
Nielsen
Dorte
D
Price
Paul A
PA
D054392:Adipokines; D001324:Autoantigens / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D037102:Lectins; D009364:Neoplasm Recurrence, Local / Q000097:blood; D009369:Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis
D054392:Adipokines; D001324:Autoantigens; D014408:Biomarkers, Tumor; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins