Early detection and prognosis of ovarian cancer using serum YKL-40
Early detection and prognosis of ovarian cancer using serum YKL-40
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DOI：
10.1200/jco.2004.09.112
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发表时间：
2004-08-15
影响因子：
45.3
通讯作者：
Spriggs, DR
中科院分区：
文献类型：
--
作者：
Dupont, J;Tanwar, MK;Spriggs, DR
YKL-40是一种分泌糖蛋白（几丁质酶家族）。我们将YKL-40与两种卵巢癌血清标志物CA125和CA15-3进行比较，以检测早期卵巢癌。材料与方法采用酶联免疫吸附法检测46例健康人、61例高危人群、33例妇科良性病变患者和50例术前确诊为主的早期卵巢癌患者血清YKL-40水平。测定血清CA125、CA15-3值。结果YKL-40的中位水平为健康受试者28 ng/mL（范围为15 ~ 166 ng/mL），无既往癌症的高危人群36 ng/mL（范围为9 ~ 69 ng/mL），既往乳腺癌高危患者44.5 ng/mL（范围为5 ~ 133 ng/mL），妇科良性病变个体38 ng/mL（范围为5 ~ 67 ng/mL） （P = NS）。卵巢癌患者术前YKL-40水平中位数为94 ng/mL（范围17 ~ 517 ng/mL，与正常和高危患者相比P < 0001）。50例患者中有36例（72%）的YKL-40升高（大于或等于62 ng/mL），而CA125和CA15-3患者中分别有23例（46%）和13例（26%）升高（P < 008）。31例早期患者中有20例（65%）血清YKL-40水平升高，而31例患者中有11例（35%）和31例CA125和CA15-3患者中有4例（13%）血清YKL-40水平升高（P = 0.039）。YKL-40水平随分期升高（P < 0.005），与分级、组织学或患者年龄无关。YKL-40值大于80 ng/mL的早期肿瘤患者预后较差（71%复发vs无复发[P = 0.034]）。结论YKL-40可能是检测早期卵巢癌的一种新的标志物。早期患者的YKL-40水平也可能预测疾病复发和生存。YKL-40在早期卵巢癌检测中的应用值得进一步探讨。
Purpose YKL-40 is a secreted glycoprotein (chitinase family). We compared YKL-40 with two ovarian cancer serum markers, CA125 and CA15-3, for the detection of early-stage ovarian cancer.Materials and Methods Serum YKL-40 levels were assayed by enzyme-linked immunosorbent assay for 46 healthy subjects, 61 high-risk individuals, 33 patients with benign gynecologic processes, and 50 preoperative patients subsequently diagnosed with predominantly early-stage ovarian cancer. Serum CA125 and CA15-3 values were obtained.Results Median YKL-40 level was 28 ng/mL (range, 15 to 166 ng/mL for healthy subjects, 36 ng/mL (range, 9 to 69 ng/mL) for high-risk individuals without prior cancer, 44.5 ng/mL (range, 5 to 133 ng/mL) for high-risk patients with prior breast cancer, and 38 ng/mL (range, 5 to 67 ng/mL) for individuals with benign gynecologic processes (P = NS). Median preoperative YKL-40 level for ovarian cancer patients was 94 ng/mL (range, 17 to 517 ng/mL; P < 0001 compared with normal and high-risk). YKL-40 was elevated (greater than or equal to 62 ng/mL) in 36 (72%) of 50 patients compared with 23 (46%) of 50 and 13 (26%) of 50 patients for CA125 and CA15-3 (P < 008). Twenty 65%) of 31 early-stage patients had elevated serum YKL-40 levels compared with 11 (35%) of 31 and four (13%) of 31 patients for CA125 and CA15-3 (P = .039). YKL-40 levels increased with stage (P < .005), regardless of grade, histology, or patient age. Patients with early-stage tumors with YKL-40 values more than 80 ng/mL had a worse prognosis (71% recurrence v no recurrence [P = .034]).Conclusion YKL-40 may represent a novel marker for the detection of early-stage ovarian cancer. YKL-40 levels in early-stage patients may also predict disease recurrence and survival. The utility of YKL-40 in detection of early-stage ovarian cancer deserves further investigation.