Abstract
BackgroundSerum/plasma YKL-40 can be a useful index that is associated with tumor development. However, the prognostic value of serum/plasma YKL-40 in patients with solid tumors is still unclear. We aimed to utilize the existing literature to investigate the prognostic value of serum/plasma YKL-40 in solid tumors.MethodsAn extensive literature search for relevant studies was conducted with the Embase, Medline and Web of Science databases. The effect on survival was measured with the hazard ratio (HR). Then, pooled HRs and 95% confidence intervals (CIs) were calculated using the random and fixed-effects models according to the heterogeneity of the included studies.ResultsThis meta-analysis was based on 41 publications and comprised a total of 7762 patients with solid tumors. The pooled HR showed that elevated serum/plasma YKL-40 was significantly associated with poor OS (HR, 1.44; 95% CI 1.33–1.56). We also found that elevated serum/plasma YKL-40 had significant prognostic effects on OS in various cancer subgroups such as gastrointestinal tumors (HR, 1.37; 95% CI 1.18–1.58), ovarian cancer (HR, 2.27; 95% CI 1.69–3.06), melanoma (HR, 1.77; 95% CI 1.18–2.67), lung cancer (HR, 1.73; 95% CI 1.35–2.23), urologic neoplasms (HR, 1.61; 95% CI 1.08–2.40) and glioblastoma (HR, 1.23; 95% CI 1.07–1.42); in contrast, the prognostic effect of serum/plasma YKL-40 was not statistically significant in breast cancer (HR, 1.07; 95% CI 0.98–1.17).ConclusionsThe available evidence supports the hypothesis that elevated serum/plasma YKL-40 is associated with poor survival in patients with solid tumors and that serum/plasma YKL-40 may serve as a novel prognostic biomarker.
Highlights
Serum/plasma YKL-40 can be a useful index that is associated with tumor development
Selection criteria and quality assessment Studies were included in the meta-analysis according to the following criteria: (1) patients with a diagnosis of solid tumor that was confirmed through histopathologic examinations; (2) sufficient data were provided to determine an estimate of the hazard ratio (HR) for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS); (3) more than 30 patients were enrolled in each study; and (4) cohort studies published in English
The pooled HR showed that elevated serum/plasma YKL-40 was Outcome HR 95% confidence intervals (CIs)
Summary
Serum/plasma YKL-40 can be a useful index that is associated with tumor development. The prognostic value of serum/plasma YKL-40 in patients with solid tumors is still unclear. We aimed to utilize the existing literature to investigate the prognostic value of serum/plasma YKL-40 in solid tumors. There were an estimated 18.1 million new cancer cases and 9.6 million cancer deaths in 2018, and cancer is expected to rank as the leading cause of death [1]. In this setting, prognostic indicators in patients with cancer are crucial. The clear expression of YKL-40 has been reported in cancer cells [4, 5]. It is suggested that this protein plays a role in inflammation, stimulation of angiogenesis and regulation of extracellular tissue remodeling and the expression of YKL-40 is increased in patients with
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