Serum Ykl-40 Levels In Patients With Cervical Cancer Are Elevated Compared To Patients With Cervical Intraepithelial Neoplasia And Healthy Controls

YKL-40 is secreted by cancer cells, macrophages and neutrophils. The exact function of YKL-40 is unknown. It may be a growth or differentiation factor, play a role in angiogenesis or protect against apoptosis. High serum YKL-40 is associated with poor prognosis in breast-, colorectal-, ovarian-, prostate-, small cell lung cancer and malignant melanoma. The aim was to examine serum YKL-40 in patients with cervical cancer and cervical intraepithelial neoplasia (CIN). YKL-40 was determined by ELISA (Quidel, Santa Clara, CA) in pretreatment serum samples from 116 patients with cervical cancer (FIGO stage la (N=5), Ib (N=55), II (N=27), III (N=25) and IV (N=4); and 152 patients with CIN. The controls included 63 healthy women undergoing sterilization and a group of 134 healthy women. Serum YKL-40 was increased (p , 0.001) in patients with cervical cancer (median 76 lg/l, range 20-2310) compared to patients with CIN (45 lg/l, 20-288), women undergoing sterilization (37 lg/l, 20-125) and healthy women (43 lg/l, 20-172). Serum YKL40 increased with increasing stage (Ia: median 36 lg/l, range 26-137; Ib: 56 lg/l, 20-984; II: 92 lg/l, 28-2310; III: 163 lg/l, 40-1474; and IV: 224 lg/l, 137-391; p , 0.001 Kruskal-Wallis test). All stage IV patients, 72% stage III, 52% stage II, 24% stage Ib, 40% stage Ia and 13% of patients with CIN had elevated serum YKL-40 compared to healthy controls. Median serum YKL-40 is elevated in patients with cervical cancer. The serum level of YKL-40 seems to be correlated to the stage.