Elevated YKL-40 expression is associated with a poor prognosis in breast cancer patients
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Guoxing Wan1,*, Longchao Xiang2,3,*, Xue Sun1,*, Xuanbin Wang2,3, Hongliang Li2,3, Wei Ge4, Fengjun Cao1
1Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
2Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, Shiyan 442000, Hubei, China
3Laboratory of Chinese Herbal Pharmacology, Oncology Center, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
4Department of Oncology, Renmin Hospital, Wuhan University, Wuhan 430060, Hubei, China
*These authors have contributed equally to this work
Fengjun Cao, email: email@example.com
Wei Ge, email: firstname.lastname@example.org
Keywords: YKL-40, breast cancer, prognosis, meta-analysis
Received: August 01, 2016 Accepted: December 07, 2016 Published: December 27, 2016
Numerous studies have investigated the prognostic role of YKL-40 in breast cancer, but yielded inconsistent results. To derive a more precise evaluation, relevant publications assessing the association between YKL-40 expression and clinical outcome of breast cancer patients were electronically searched and identified. A combined analysis of included studies was performed using fixed- or random-effect model to calculate the pooled hazard ratio (HR) or odds ratio(OR) and 95% confidence interval (95%CI) for the assessment of the association. Ten eligible studies involving 1250 patients were ultimately included in the meta-analysis. Overall, the pooled analysis showed that elevated YKL-40 expression was significantly associated with a poor overall survival(OS: HR=1.48, 95%CI= 1.11-1.97) and disease-free survival(DFS: HR=1.51, 95%CI= 1.10-2.07). The subgroup analysis by detection methods revealed an unfavorable OS in breast cancer patients with elevated YKL-40 expression evaluated by IHC(HR=1.39, 95%CI=1.12-1.71) but not by ELISA/RIA. Also, the stratification analysis by ethnicity showed a significant association between increased YKL-40 expression and shorter OS of breast cancer patients in western population(HR=1.51, 95%CI=1.03-2.21) as well as Asian population (HR=1.40, 95%CI= 1.05-1.86). Similarly, the subgroup analysis by detection methods revealed a significantly inferior DFS in breast cancer patients with increased YKL-40 expression disregarding the use of IHC(HR=2.02, 95%CI=1.47-2.79) or ELISA/RIA(HR=1.06, 95%CI= 1.02 -1.10). Additionally, increased YKL-40 expression was found to significantly correlate with larger tumor size (OR=2.38, 95%CI=1.41-4.05).The present meta-analysis indicate that elevated YKL-40 expression is associated with a poor prognosis in breast cancer patients. YKL-40 may serve as a promising predictive biomarker of prognosis of breast cancer.
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