Detections Of Plasma And Tissue YKL-40 In Esophageal Carcinoma And Their Clinical Applications

Objective: ykl-40 gene was a candidate oncogene in the past years and Ykl-40 was highly expressed in different types of tumor.We aimed to evaluate the clinical applications of plasma YKL-40 in esophageal carcinoma,and to establish a high throughput immunohistochemical technique of tissue microarray on YKL-40 protein from esophageal tissue in order to reveal its clinical significance.Methods: 1.Plasma YKL-40 was measured in 127 patients referred with primary,recurrent esophageal carcinoma or after clinical surgery therapy and 11 patients referred with esophageal diseases without carcinoma and 29 healthy subjects using the EIA kit from Quidel company USA.2.Levels of plasma YKL-40 were compared in different pathologic appearances and clinical information,including stage,tumor cell differentiation,lymphoid nodes metastasis,cancer embolus,size,site,sex and age.3.Evelating the predictive value of plasma YKL-40 for esophageal carcinoma surgical operation therapy.4.Receiver operation curve was performed to analysis the diagnostic value of plasma YKL-40 for esophageal carcinoma.5.Developing a high throughput immunohistochemical technique of tissue microarray on YKL-40 protein from esophageal cancer and adjacent tissue.6.The data was analyzed by Kruskal-Wallis H test and Nemenyi rank sum test with SPSS17.0 software.Results: 1.Concentration of plasma YKL-40(121.02ng/ml)was increased in primary esophageal cancer patients than that of healthy control(33.60ng/ml)(p<0.001).Patients referred with esophageal diseases without carcinoma(149.95ng/ml)had a significantly higher YKL-40 levels than healthy control(p=0.036),but no significant difference from esophageal cancer patients.2.Concentration of YKL-40 in tumor size shorter than 3cm and longer than 5cm esophageal carcinoma patients was significantly higher than the middle size patients,with the median value as 140.77ng/ml,136.82ng/ml and 95.37ng/ml,respectively(p<0.05).The levels of YKL-40 in middle esophageal carcinoma were significantly lower than those for upper and lower esophageal carcinoma.And their median YKL-40 values were 92.82ng/ml,155.66ng/ml and 161.15ng/ml,respectively(p<0.05).3.Patients with lymph nodes metastasis had higher plasma YKL-40(distant metastasis as 135.49ng/ml and near metastasis as 95.19ng/ml)than patients without lymph nodes metastasis(76.7ng/ml)(p=0.005).Plasma YKL-40 level in patients with cancer embolus(160.3ng/ml)was higher than those without cancer embolus(74.72ng/ml)(p=0.012).4.Plasma YKL-40 level was closely related with esophageal carcinoma stage.Concentration of YKL-40 ranged from 68ng/ml,71.61ng/ml,146.85ng/ml to 110.95ng/ml as the carcinoma stage from stage ?to ?.It showed higher YKL-40 level at stage ? and ? than stage?and?(p=0.016).Plasma YKL-40 was higher in esophageal adenocarcinoma than esophageal squamous cell carcinoma(ESCC).But no correlation was found between plasma YKL-40 and cell differentiation on ESCC.Concentration of YKL-40 was 130.9ng/ml,88.35ng/ml and102.03ng/ml for high,middle and low differentiation,respectively.Plasma YKL-40 was increased in patients with ulcerative esophageal carcinoma patients(148.93ng/ml)than medullary esophageal carcinoma(69.23ng/ml).5.ROC was analyzed according primary esophageal carcinoma,esophageal disease without carcinoma and healthy.Area under ROC curve was 0.791 and 82.06ng/ml was the best leak point of YKL-40 in esophageal carcinoma.The sensitivity,specificity,concordance rate,negative likelihood ratio,positive likelihood ratio,were 68.9%,80.0%,71.08%,38.56%,93.39% respectively.6.YKL-40 was expressed in high differentiation squamons cells at both cancer tissue and adjacent tissue by immunohistochemistry.Conclusions: 1.Concentration of plasma YKL-40 in esophageal carcinoma was higher than healthy control and was associated with esophageal carcinoma size and site.2.Plasma YKL-40 was associated with esophageal carcinoma lymph nodes metastasis and cancer embolus.3.Plasma YKL-40 was associated with esophageal carcinoma stage.4.ROC analysis showed that plasma YKL-40 was of certain value in diagnosing esophageal carcinoma.5.High throughput immunohistochemical technique of tissue microarray for detection of YKL-40 was established for diagnosis of escphageal cancer.