High serum concentration of YKL-40 is associated with short survival in patients with acute myeloid leukemia
High serum concentration of YKL-40 is associated with short survival in patients with acute myeloid leukemia
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DOI：
10.1158/1078-0432.ccr-05-1317
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发表时间：
2005-12-15
影响因子：
11.5
通讯作者：
Johnsen, HE
中科院分区：
文献类型：
--
作者：
Bergmann, OJ;Johansen, JS;Johnsen, HE
目的：YKL-40由癌细胞、巨噬细胞和中性粒细胞分泌。它可能是一种生长或分化因子，在血管生成中起作用，或防止细胞凋亡。高血清YKL-40与实体癌预后不良相关。本研究旨在检测急性髓系白血病（AML）患者血清YKL-40水平。实验设计：采用ELISA法检测77例近期确诊的AML患者化疗前和化疗第一个月的血清YKL-40水平。40例（52%）AML患者血清YKL-40升高（与年龄匹配的健康受试者相比），其生存期短于血清YKL-40正常的患者（中位数，128天;四分位距，18-629天对比386天;四分位距，180-901; P = 0.018 Mann-Whitney检验）。血清YKL-40的单因素分析（经过对数转换并作为连续协变量处理）显示与化疗开始后第一个月内的生存率显着相关[风险比（HR），1.7; 95%置信区间（CI），1.2-2.4; P = 0.002]，前12个月（HR，1.6; 95% CI，1.2-2.0; P = 0.0002）和总生存期（HR，1.3; 95% CI，1.1-1.6; P = 0.003）。多因素考克斯分析显示血清YKL-40是生存期的独立预后变量（第1个月：HR，1.7; P = 0.011; 12个月：FIR 1.6; P = 0.0002;总生存期：HR，1.4; P = 0.002）。化疗开始时血清YKL-40升高是第一个月内肺炎的危险因素，血清YKL-40在肺炎时升高（P0.002），在无感染的患者中无变化。结论：血清YKL-40是AML患者生存的预后生物标志物。它在AML和感染中的作用需要确定。
Purpose: YKL-40 is secreted by cancer cells, macrophages, and neutrophils. It may be a growth or differentiation factor, play a role in angiogenesis, or protect against apoptosis. High serumYKL-40 is associated with poor prognosis in solid carcinomas. The aim was to examine serum YKL-40 in patients with acute myeloid leukemia (AML).Experimental Design: YKL-40 was measured by ELISA in serum from 77 patients recently diagnosed with AML before and during the first month of chemotherapy.Results: Forty (52%) of the AML patients had elevated serum YKL-40 (compared with age-matched healthy subjects) and their survival was shorter than in patients with normal serum YKL-40 (median, 128 days; interquartile range, 18-629 days versus 386 days; interquartile range, 180-901; P = 0.018 Mann-Whitney test). Univariate analysis of serumYKL-40 (logarithmically transformed and treated as a continuous covariate) showed significant association with survival within the first month after start of chemotherapy [hazard ratio (HR), 1.7; 95% confidence interval (CI), 1.2-2.4; P = 0.002], first 12 months (HR, 1.6; 95% Cl, 1.2-2.0; P = 0.0002), and overall survival (HR, 1.3; 95% Cl, 1.1-1.6; P = 0.003). Multivariate Cox analysis showed that serum YKL-40 was an independent prognostic variable for survival (first month: HR, 1.7; P = 0.011; 12 months: FIR 1.6; P = 0.0002; overall survival: HR, 1.4; P = 0.002). High serum YKL-40 at start of chemotherapy was a risk factor for pneumonia within the first month, and serumYKL-40 increased (P 0.002) at time of pneumonia and was unchanged in patients without infections.Conclusions: SerumYKL-40 is a prognostic biomarker of survival in AML patients. Its role in AML and infections needs to be determined.