Serum YKL-40 in risk assessment for colorectal cancer: A population based, prospective study of 4496 subjects at risk of colorectal cancer
Menée à partir d'échantillons sériques prélevés sur 2 064 hommes et 2 432 femmes présentant un risque de cancer colorectal (âge médian : 61 ans), cette étude évalue l'intérêt de mesurer le niveau de la protéine YKL-40 pour prédire la survenue de la maladie
The aim of the present study was to test the hypothesis that high serum YKL-40 associates with colorectal cancer (CRC) in subjects at risk of CRC. We measured serum YKL-40 in a prospective study of 4496 Danish subjects (2064 men, 2432 women, median age 61 years (range 18-97)) referred to endoscopy due to symptoms or other risk factors for CRC. Blood samples were collected just before large bowel endoscopy. Serum YKL-40 was determined by ELISA. Serum YKL-40 was higher (p<0.0001, unadjusted for confounding covariates) in subjects diagnosed with CC (median 126 µg/L, 25-75%: 80-206 µg/L) and RC (104, 72-204 µg/L) compared to subjects with adenoma (84, 53-154 µg/L), other non-malignant findings (79, 49-138 µg/L), and no findings (62, 41-109 µg/L). Serum YKL-40 independently predicted CRC (OR=1.53, 95% CI: 1.40-1.67, AUC=0.68, p<0.0001). Restricting the analysis to subjects with no co-morbidity increased the OR for serum YKL-40 to predict CRC (OR=1.82, 1.58-2.08, AUC=0.73, p<0.0001). Combining serum YKL-40 and CEA demonstrated that both were significant (YKL-40, OR=1.27, 1.16-1.40); CEA, OR=1.92, 1.75-2.10; AUC=0.75, p<0.0001) (OR for a 2-fold difference in marker level). Multivariable analysis (YKL-40, CEA, age, gender, BMI, center) showed that serum YKL-40 was a predictor for CRC in individuals without co-morbidity (OR=1.25, 1.05-1.40, p=0.012), whereas this was not the case for those with co-morbidity (OR=0.98, 0.84-1.14, p=0.80). In conclusion, high serumYKL-40 in subjects suspected of CRC and without co-morbidity associates with CRC. Determination of serum YKL-40 may be useful in combination with other biomarkers in risk assessment for CRC.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2015