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Serum YKL-40 levels as a prognostic factor in patients with locally advanced breast cancer

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Abstract

Introduction

YKL-40 is a growth factor for connective tissue cells; it also stimulates the migration of endothelial cells. YKL-40 is secreted by cancer cells, and elevated serum levels have been associated with poorer prognosis in metastatic breast cancer. In the present study we evaluated the prognostic role of serum YKL-40 levels in patients with locally advanced breast cancer.

Methods

YKL-40 levels were measured using ELISA in serum samples obtained from 45 breast cancer patients prior to surgery and chemotherapy. The median follow-up time was 46 months (range, 10–96 months). All patients underwent surgery after chemotherapy. During the follow-up period, 21 patients relapsed and there were 17 deaths.

Results

The median serum YKL-40 concentration in patients with locally advanced breast cancer was 149.5 μg/l (range, 25.0–1021.3 μg/l). This was higher than levels observed in healthy female controls but the difference was not significant (P=0.44). Serum YKL-40 levels were also higher in patients with tumour size >2 cm and node-positive disease but again the differences were not significant (P>0.05). Tumour volume was correlated with serum YKL-40 levels (r=0.308, P=0.039). High serum YKL-40 levels were associated with shorter disease-free and overall survival although this trend failed to reach significance (P>0.05). Multivariate analysis including tumour size, lymph node status, oestrogen and progesterone receptor status, tumour grade, and serum YKL-40 levels indicated that serum YKL-40 levels were an independent prognostic variable for overall survival (hazard ratio, 1.004; 95% confidence intervals: 1.00, 1.07; P=0.027). Tumour size, lymph node status and oestrogen receptor status were also independent prognostic variables for overall survival (P<0.05).

Conclusion

Our results show that serum levels of the growth factor YKL-40 may be a useful prognostic indicator of outcome for patients with locally advanced breast cancer. Further studies are required to fully elucidate the biological function of YKL-40 in breast cancer.

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Authors and Affiliations

  1. Department of Medical Oncology, Gazi University Medical School, Ankara, Turkey

    Deniz Yamac, Banu Ozturk, Ugur Coskun & Ramazan Yildiz

  2. Department of General Surgery, Gazi University Medical School, Ankara, Turkey

    Ercument Tekin

  3. Department of Biochemistry, Gazi University Medical School, Ankara, Turkey

    Banu Sancak

  4. Department of General Surgery, Demetevler Oncology Hospital, Demetevler, Ankara, Turkey

    Can Atalay

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  1. Deniz Yamac
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  2. Banu Ozturk
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  3. Ugur Coskun
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  4. Ercument Tekin
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  6. Ramazan Yildiz
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  7. Can Atalay
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Correspondence to Ugur Coskun.

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Yamac, D., Ozturk, B., Coskun, U. et al. Serum YKL-40 levels as a prognostic factor in patients with locally advanced breast cancer. Adv Therapy 25, 801–809 (2008). https://doi.org/10.1007/s12325-008-0082-2

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  • DOI: https://doi.org/10.1007/s12325-008-0082-2

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