High serum YKL-40 levels in patients with primary breast cancer is related to short recurrence free survival

Breast Cancer Res Treat. 2003 Jul;80(1):15-21. doi: 10.1023/A:1024431000710.


YKL-40 is a growth factor for connective tissue cells and stimulates migration of endothelial cells. YKL-40 is secreted by cancer cells, and elevated serum YKL-40 in patients with metastatic breast cancer and colorectal cancer is associated with a poorer prognosis as compared to patients with normal serum YKL-40. In the present study we evaluated the associations of preoperative serum YKL-40 in 271 patients with primary breast cancer in relation to relapse-free survival and overall survival. The median follow-up time was 5.9 years. There were 77 relapses and 69 patients died. The median serum YKL-40 concentration in the patients was 57 microg/l (range 22-688 microg/l) and significantly elevated (p < 0.0001) compared to serum YKL-40 in healthy females. Nineteen percent of the patients had high serum YKL-40 (i.e., >95 percentile of healthy females). Patients with high serum YKL-40 had shorter relapse-free interval (hazard ratio (HR) = 1.77, 95% confidence interval (CI): 1.06-2.95, p = 0.028) and overall survival (HR = 1.78, 95% CI: 1.04-3.05, p = 0.036) than patients with normal serum YKL-40. Serum YKL-40 was higher (p = 0.005) in lymph node positive patients as compared to lymph node negative patients. Multivariate analysis including lymph node status, estrogen receptor status, tumor size, age, menstrual status and serum YKL-40 showed that serum YKL-40 was an independent prognostic variable of relapse-free survival (HR = 1.73, 95% CI: 1.03-2.91, p = 0.039). Our results show that serum YKL-40 in patients with primary breast cancer at time of operation is only elevated in a small group of patients, but these patients have a shorter recurrence free interval. Further studies are required to determine the biological function of YKL-40 in breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Autoantigens / blood*
  • Biomarkers, Tumor / blood*
  • Breast Neoplasms / immunology*
  • Breast Neoplasms / mortality*
  • Chitinase-3-Like Protein 1
  • Disease-Free Survival
  • Female
  • Glycoproteins / blood*
  • Humans
  • Lectins
  • Middle Aged
  • Prognosis
  • Survival Analysis


  • Adipokines
  • Autoantigens
  • Biomarkers, Tumor
  • CHI3L1 protein, human
  • Chitinase-3-Like Protein 1
  • Glycoproteins
  • Lectins