Prognostic and diagnositic value of serum and urine humancartilage-glycoprotein-39 in patients with pancreatic cancer

Abstract

Objective To explore the prognostic and diagnositic value of serum and urine humancartilage-glycoprotein-39(YKL-40) in patients with pancreatic cancer. Methods A total of 58 pancreatic cancer patients and 50 healthy controls were enrolled as pancreatic cancer group and control group in the Maternity and Child health Care Center of Jingmen and the Second People′s Hospital of Jingmen from July 2014 to July 2017. The levels of serum and urine YKL-40 were detected by ELISA assay. The diagnostic efficiency of serum YKL-40 was determined by receiver operating characteristic. According to the serum, urine YKL-40 concentrations, pancreatic cancer patients were divided into two groups: the YKL-40 high group and the YKL-40 low group. The correlation between YKL-40 levels and clinical characteristics was analyzed by χ2 test. Median survival was calculated by Kaplan-Meier method. The risk factors of patients with poor prognosis were analyzed by univariate and multivariate Cox regression analysis model. Results The levels of serum YKL-40 were significantly increased in the pancreatic cancer group compared to those of the control group [(117.16 ± 46.78) ng/ml vs. (68.88 ± 12.37) ng/ml] (P < 0.05). The area under ROC curve(AUC) of serum YKL-40 for the diagnosis of pancreatic cancer were 0.839 (95% CI 0.755-0.902), with a sensitivity and specificity of 67.2% and 98.0%, respectively. Age, differentiation, vascular invasion, tumor TNM, positive surgical margin stage had significant relationship with serum YKL-40 level, and vascular invasion, tumor TNM, positive surgical margin stage had significant relationship with urine YKL-40 level (all P<0.05). Compared with lower YKL-40 group, the median survival of higher YKL-40 group decreased remarkablely, and the difference was statistically (all P<0.05). A high serum YKL-40 level (HR: 3.696, 95% CI 1.680-8.130, P=0.001), high urine YKL-40 level (HR: 2.846, 95% CI 1.311-6.178, P=0.008), vascular invasion (HR: 0.308, 95% CI 0.146-0.651, P=0.002), high tumor TNM (HR: 1.997, 95% CI 1.005-3.967, P=0.048) was identified as an independent risk factor of poor prognosis for patients with pancreatic cancer (all P<0.05). Conclusions Serum YKL-40 can be used as a diagnostic marker for pancreatic cancer, and both serum and urine YKL-40 can be served as prognostic marker for pancreatic cancer. However, urine YKL-40 has a better clinical value for this index with advantages of non-invasive operation. Key words: Pancreatic neoplasms; Diagnosis; Prognosis; Humancartilage-glycoprotein-39