title: Serum YKL-40 independently predicts outcome after transcatheter arterial chemoembolization of hepatocellular carcinoma.
abstract: BACKGROUND
  Transcatheter arterial chemoembolization (TACE) is the most widely used treatment option for unresectable hepatocellular carcinoma (HCC). Elevated serum YKL-40 level has been shown to predict poor prognosis in HCC patients undergoing resection. This study was designed to validate the prognostic significance of serum YKL-40 in patients with HCC undergoing TACE treatment.
  
  
  METHODS
  Serum YKL-40 level was determined by enzyme-linked immunosorbent assay. Overall survival (OS) was evaluated with the Kaplan-Meier method and compared by the log-rank test. Multivariate study with Cox proportional hazard model was used to evaluate independent prognostic variables of OS.
  
  
  RESULTS
  The median pretreatment serum YKL-40 in HCC patients with was significantly higher than that in healthy controls (P<0.001). The YKL-40 could predict survival precisely either in a dichotomized or continuous fashion (P<0.001 and P = 0.001, respectively). Multivariate Cox regression analysis indicated that serum YKL-40 was an independent prognostic factor for OS in HCC patients (P = 0.001). In further stratified analyses, YKL-40 could discriminate the outcomes of patients with low and high alpha-fetoprotein (AFP) level (P = 0.006 and 0.016, respectively). Furthermore, the combination of serum YKL-40 and AFP had more capacity to predict patients' outcomes.
  
  
  CONCLUSIONS
  Serum YKL-40 was demonstrated to be an independent prognostic biomarker in HCC patients treated with TACE. Our results need confirmation in an independent study.
authors.affiliation: Department of Clinical Laboratory, Jinan Infectious Disease Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Cheng-Bao
authors.initials: CB
authors.lastname: Zhu
authors.forename: Can
authors.initials: C
authors.lastname: Wang
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Chen
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Ma
authors.forename: Shi-Cai
authors.initials: SC
authors.lastname: Zhang
authors.forename: Liang
authors.initials: L
authors.lastname: Su
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Tian
authors.forename: Zhong-Tao
authors.initials: ZT
authors.lastname: Gai
mesh_terms: D054392:Adipokines / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D002405:Catheterization, Central Venous; D016461:Chemoembolization, Therapeutic; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006801:Humans; D037102:Lectins / Q000097:blood*; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D054392:Adipokines; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins