title: Overexpression of YKL-40 is an independent prognostic marker in gastric cancer.
abstract: YKL-40 is a growth factor for connective tissue cells and a migration factor for endothelial cells. Elevated serum level of YKL-40 has been associated with poor prognosis in many cancers. However, the status of YKL-40 expression and its clinical/prognostic significance in gastric cancer are unclear. In this study, the expression of YKL-40 was studied by immunohistochemistry in gastric cancer tissue microarray containing 172 primary gastric cancer cases and 70 adjacent nonneoplastic mucosa specimens. The correlations between YKL-40 expression and clinicopathologic features, as well as activation of PI3K/Akt pathways were addressed. Expression of YKL-40 was significantly higher in gastric cancer tissues than that in adjacent nonneoplastic tissues. Overexpression YKL-40 was found in 28.4% of gastric cancers and was significantly associated with tumor invasion (P = .007) and lymph node metastasis (P = .009). For survival study, overexpression of YKL-40 was significantly associated with worse outcome (P = .001). When known clinical variables were added to a multivariate analysis, TNM stage, tumor size, and overexpression of YKL-40 emerged as independent prognostic factors. Further study indicated that the oncogenic function of YKL-40 might be through the activation of Akt pathway. These results suggest that overexpression of YKL-40 is correlated with the aggressive behavior of tumor cells, which could be used as an independent molecular marker for the predicting poor prognosis of patients with gastric cancer.
authors.affiliation: Laboratory of Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jiong
authors.initials: J
authors.lastname: Bi
authors.forename: Sze-Hang
authors.initials: SH
authors.lastname: Lau
authors.forename: Zi-Li
authors.initials: ZL
authors.lastname: Lv
authors.forename: Dan
authors.initials: D
authors.lastname: Xie
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.forename: Ying-Rong
authors.initials: YR
authors.lastname: Lai
authors.forename: Jue-Min
authors.initials: JM
authors.lastname: Zhong
authors.forename: Hui-qun
authors.initials: HQ
authors.lastname: Wu
authors.forename: Qiao
authors.initials: Q
authors.lastname: Su
authors.forename: Yu-long
authors.initials: YL
authors.lastname: He
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Zhan
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Wen
authors.forename: Xin-Yuan
authors.initials: XY
authors.lastname: Guan
mesh_terms: D054392:Adipokines; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006023:Glycoproteins / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D037102:Lectins / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D046888:Tissue Array Analysis; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins