Plasma YKL-40 as a biomarker in patients with nonmetastatic bone and soft tissue sarcomas: a prospective exploratory clinical study

• Published in: IJS oncology 2020-06, Vol.5 (3), p.e871-e877
• Main Authors: Thorn, Andrea P., Harving, Mette L., Lausten, Gunnar S., Johansen, Julia S., Sørensen, Michala S., Petersen, Michael M.
• Format: Article
• Language: English
• ISSN: 2471-3864; 2471-3864
• DOI: 10.1097/IJ9.0000000000000087

YKL-40 is a glycoprotein with a role in inflammation, tissue remodeling, tumor angiogenesis, and protection against apoptosis. We hypothesized that high preoperative plasma YKL-40 in patients with nonmetastatic bone and soft tissue sarcoma (STS) is associated with short overall survival (OS), and that plasma YKL-40 is an independent predictor for OS. Plasma was collected preoperatively from 65 patients with nonmetastatic bone (n = 14) or STS (n = 51) in the lower extremities (n = 43), the upper extremities (n = 16) or the trunk wall/spine (n = 6). All patients underwent surgical cancer treatment. Twenty patients developed metastases during the follow-up period (minimum 5 y). The plasma concentration of YKL-40 was determined by enzyme-linked immunosorbent assay. Twenty-seven patients died [mean3.2 (range0.2-7.3) y postoperatively] and 38 patients were still alive after a follow-up of mean 6.9 (5.8-8.2) years postoperatively. Plasma YKL-40 was higher in patients who died during follow-up (P = 0.008), in males (P = 0.007) and in patients 61 years of age and above (P = 0.001). The 5-year OS was 68% and OS was lower in patients with high (≥95% percentile age-corrected) plasma YKL-40 (P = 0.021), age 61 years and above (P = 0.013), high histologic malignancy grade (P = 0.047) and male sex (P = 0.051). Multivariable analysis showed that only plasma YKL-40 (age-corrected (hazard ratio = 2.80, 95% confidence interval1.13-6.91, P = 0.026) and malignancy grade (hazard ratio = 9.9 × 107, 95% confidence interval0-∞, P = 0.007) remained independent prognostic factors for OS. High preoperative plasma YKL-40 was related to short OS in patients with nonmetastatic bone and STS and plasma YKL-40 (age-corrected) was an independent prognostic risk factor for OS.