YKL-40 in the diagnosis, prediction of prognosis, and platinum sensitivity in serous epithelial ovarian cancer.

İlker Kahramanoğlu,Hasan Turan,Gönül Şimşek,Macit Arvas,Remise Gelişgen,Veysel Şal,Tugan Beşe,Hafize Uzun,Fuat Demirkıran,Nedim Tokgözoğlu

doi:10.4274/tjod.28459

Abstract

Objective:To evaluate the use of YKL-40 in the discrimination between benign and malignant adnexal mass and to determine its prognostic value in assessing residual tumor after primary cytoreduction and platinum sensitivity in serous epithelial ovarian carcinoma (EOC). Materials and Methods:During the three years from January 2015 to December 2017, a nonconsecutive series of 100 patient (60 malignant, 40 benign) who underwent surgery for an adnexal mass were enrolled in the study. Preoperatively, serum samples were collected for YKL-40 level analysis.Results:YKL-40 [receiver operator characteristics (ROC)-area under curve (AUC)=0.83] was a significantly better predictor of EOC than cancer antigen-125 (ROC-AUC=0.75). Using a cut-off for YKL-40 of 47.7 ng/mL had a sensitivity of 80% and a specificity of 70%. Higher serum YKL-40 levels were associated with advanced stage, higher grade, residual tumor after primary cytoreduction and recurrence. Platinum-sensitive patients had significantly elevated levels of YKL-40 compared with platinum-resistant or refractory patients.Conclusion:The results obtained from our study support the use of serum YKL-40 for the discrimination between malignant and benign ovarian tumors. YKL-40 levels in patients with serous EOC may also predict disease residual disease after primary cytoreduction and recurrence. Further studies are needed to understand the relationship between YKL-40 and platinum sensitivity.

Highlights

Ovarian cancer is a common gynecologic malignancy associated with poor prognosis worldwide
Patients who are at higher risk of residual tumor after primary cytoreduction should be isolated in the preoperative period, and these should benefit from neoadjuvant chemotherapy
We aimed to evaluate the usefulness of YKL-40 in the discrimination of benign and malignant adnexal masses and to determine the efficacy of YKL-40 in the preoperative estimation of the prognostic parameters such as stage and grade of the disease, residual tumor after primary cytoreduction, and response to platinum-based chemotherapy

Summary

Introduction

Ovarian cancer is a common gynecologic malignancy associated with poor prognosis worldwide. More than 70% of women are diagnosed as having stage III or IV disease, which has a 5-year survival rate of around only 25%(1) This poor prognosis emphasizes the need for early detection in screening programs and prognostic markers to guide individual cancer treatment. A number of studies showed that leaving no residual tumor following primary debulking surgery was the single most important independent prognostic factor in advanced EOC[4,5]. We aimed to evaluate the usefulness of YKL-40 in the discrimination of benign and malignant adnexal masses and to determine the efficacy of YKL-40 in the preoperative estimation of the prognostic parameters such as stage and grade of the disease, residual tumor after primary cytoreduction, and response to platinum-based chemotherapy

Methods

Results

Conclusion