上皮性卵巢癌患者腹水YKL-40表現量與臨床預後的關聯性

背景：上皮性卵巢癌是全世界最致命的婦女癌症。大多數卵巢癌初次診斷時已是晚期(第三或第四期)，也就是腫瘤瀰漫在腹腔與骨盆腔，並且產生大量腹水。目前對於卵巢癌的標準治療是減積手術加上術後化學治療，但是卵巢癌往往在治療結束的兩年內復發。已經在許多慢性發炎疾病與癌症發現來自CHI3L1基因表現的YKL-40蛋白，本研究將分析上皮性卵巢癌患者腹水中的YKL-40量與患者臨床預後的關聯性。研究方法：運用酵素免疫分析法Enzyme-linked immunosorbent assay (ELISA)衡量上皮性卵巢癌患者腹水中YKL-40含量，與患者臨床及病理表現的相關性。結果：本研究收集150名卵巢癌患者。YKL-40含量與癌症期別、腹水是否發現腫瘤細胞、癌症復發，以及患者死亡相關。單變數分析中，高含量的YKL-40的患者其中位無病存活期(disease-free survival; DFS)較短(風險比：3.38，95%信賴區間：2.06−5.53，p<0.001)，患者的整體存活期(overall survival)較短(風險比：3.56，95%信賴區間：1.77−7.16，p<0.001)。多變數分析模式下，患者的整體存活期(overall survival)也較短(風險比：2.54，95%信賴區間：1.13−5.69，p=0.024)。漿液性腫瘤、癌症期別、腫瘤組織惡性度與YKL-40含量是影響預後的因子。結論：卵巢癌晚期、惡性腹水、癌症復發，以及患者死亡，與YKL-40含量高相關。腹水中YKL-40含量是影響卵巢癌患者預後的因子。

關鍵字

卵巢癌； YKL-40 ； CHI3L1 ；預後因子；腹水

並列摘要

Background: Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancies all over the world. Most cases are diagnosed at advanced stages (stage III–IV) with disseminated intra-abdominal metastasis and ascites. The current standard treatment of ovarian cancer is surgery and adjuvant chemotherapy. While, disease recurrence occurs within 2 years. YKL-40, the product of CHI3L1 gene, is expressed in several human inflammation diseases or cancers. In the study, we measured the expression of YKL 40 in the ascites of EOC patients and evaluated if YKL-40 could be a prognostic factor of EOC patients. Methods: We then performed Enzyme-linked immunosorbent assay (ELISA) to evaluate the amount of YKL40 in the ascites of EOC patients. The correlation of YKL-40 expression and these clinic-pathologic parameters and the outcome of EOC patients were analyzed. Results: We first collected and stored the ascites of 150 EOC patients. The expression of YKL-40 in ascites of EOC patients were associated with advanced FIGO stage, positive ascites cytology, disease recurrence and disease-related death. Higher expression of YKL-40 in ascites of EOC patients were associated with shorter DFS (hazard ratio, 3.38; 95% confidence interval, 2.06-5.53; P < 0.001) and shorter OS (hazard ratio, 3.56; 95% confidence interval, 1.77-7.16; P < 0.001) by univariate analyses. By multivariate analyses. shorter OS (hazard ratio, 2.54; 95% confidence interval, 1.13-5.69; P = 0.024). Serous histology, FIGO stage, tumor grade, and the expression of YKL-40 are independent prognostic factors. Conclusions: EOC patients with advanced stage, malignant ascites, tumor recurrence and tumor-related death had significantly higher YKL-40 levels. YKL-40 in ascites was a prognostic factor for EOC patients.

並列關鍵字

ovarian cancer ； YKL-40 ； CHI3L1 ； prognostic factor ； ascites

參考文獻

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上皮性卵巢癌患者腹水YKL-40表現量與臨床預後的關聯性

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