title: Diagnostic and prognostic values of preoperative serum levels of YKL-40, HE-4 and DKK-3 in endometrial cancer.
abstract: OBJECTIVE
  The objective of this study is to determine the efficiency of YKL-40, HE-4 and DKK-3 levels in early diagnosis of patients with endometrial cancer and in the pre-operative estimation of the prognostic parameters such as stage, grade and the extension of the disease.
  
  
  METHODS
  In this prospective study, 50 patients diagnosed with endometrial cancer and 50 women as a control group, who applied to Dokuz Eylul University and Ege University Faculties of Medicine, Obstetrics and Gynecology Clinics between May 2011-May 2012 were included. CA125, HE-4, YKL-40 and DKK-3 serum levels were measured by ELISA and compared between two groups. The relation between serum levels and histopathological results, extension of disease and prognostic factors were analyzed.
  
  
  RESULTS
  Preoperative serum CA125, HE-4 and YKL-40 levels were significantly higher in endometrial cancer group (p<0.001). Serum HE-4 levels were significantly higher in advanced stages (p=0.004). When we examined early stage patients, YKL-40 levels were significantly higher in non-endometrioid histology compared with endometrioid adenocarcinoma (p=0.022). We also examined the relation between the markers and prognostic factors. Different from other markers, HE-4 levels were significantly higher in endometrial cancer patients who had lymphovascular space involvement, lower uterine segment involvement, endocervical stromal involvement, and deep myometrial invasion.
  
  
  CONCLUSIONS
  YKL-40 and HE-4 were significantly higher in patients with endometrial cancer. HE-4 seems to be superior to YKL-40 in discriminating early and advanced stages. Additionally, HE4 is significantly correlated with prognostic factors. HE-4 and YKL-40 may be successful in early determination of endometrial cancer and in detection of high risk subsets before surgery.
authors.affiliation: Fatma Hatun Hospital, Department of Obstetrics and Gynecology, Bolu, Turkey. Electronic address: drpinarkarabacak@yahoo.com.tr.
authors.forename: Pınar
authors.initials: P
authors.lastname: Kemik
authors.affiliation: Dokuz Eylül University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: bahadir.saatli@deu.edu.tr.
authors.forename: Bahadır
authors.initials: B
authors.lastname: Saatli
authors.affiliation: Ege University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: nuri-yildirim@hotmail.com.
authors.forename: Nuri
authors.initials: N
authors.lastname: Yıldırım
authors.affiliation: Cagsu Hospital, Department of Obstetrics and Gynecology, Bolu, Turkey. Electronic address: vahitdogukemik@gmail.com.
authors.forename: Vahit Doğu
authors.initials: VD
authors.lastname: Kemik
authors.affiliation: Buca Children and Women Hospital, Department of Biochemistry, Izmir, Turkey. Electronic address: dr_banu_deveci@yahoo.com.
authors.forename: Banu
authors.initials: B
authors.lastname: Deveci
authors.affiliation: Ege University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: terekmc@yahoo.com.
authors.forename: Mustafa Coşan
authors.initials: MC
authors.lastname: Terek
authors.affiliation: Dokuz Eylül University, Faculty of Medicine, Department of Biochemistry, Izmir, Turkey. Electronic address: semra.kocturk@deu.edu.tr.
authors.forename: Semra
authors.initials: S
authors.lastname: Koçtürk
authors.affiliation: Dokuz Eylül University, Faculty of Medicine, Department of Pathology, Izmir, Turkey. Electronic address: meral.koyuncuoglu@deu.edu.tr.
authors.forename: Meral
authors.initials: M
authors.lastname: Koyuncuoğlu
authors.affiliation: Dokuz Eylül University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: saygiliu@hotmail.com.
authors.forename: Uğur
authors.initials: U
authors.lastname: Saygılı
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D054392:Adipokines / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D016022:Case-Control Studies; D018925:Chemokines; D000071451:Chitinase-3-Like Protein 1; D016889:Endometrial Neoplasms / Q000097:blood*; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D037102:Lectins / Q000097:blood*; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism*; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D054392:Adipokines; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C084533:CHI3L1 protein, human; D018925:Chemokines; D000071451:Chitinase-3-Like Protein 1; C498624:DKK3 protein, human; D036341:Intercellular Signaling Peptides and Proteins; D037102:Lectins; C451759:MUC16 protein, human; D008565:Membrane Proteins; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human
keywords: DKK-3; Endometrial cancer; HE-4; Prognostic factors; Tumor markers; YKL-40