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Abstract：
UNASSIGNED: Anal squamous cell carcinoma (ASC) is a rare gastrointestinal malignancy showing an increased incidence over the past decades. YKL-40 is an immune modulator and pro-angiogenetic factor that showed a promising prognostic and predictive potential in several malignancies, but limited data are available for ASC. This study aims to provide an extensive evaluation of the prognostic and predictive role of YKL-40 in a multicenter cohort of ASC patients.
UNASSIGNED: We retrospectively retrieved 72 consecutive cases of ASC diagnosed between February 2011 and March 2021. Both serum and tissue protein expression of YKL-40 were assessed, the latter in ASC tumor cells and peritumor immune cells.
UNASSIGNED: Increased YKL-40 serum levels at the time of diagnosis were associated with older age (p = 0.035), presence of cardiovascular/metabolic comorbidities (p = 0.007), and death for any cause (p = 0.011). In addition, high serum levels of YKL-40 were associated with a poor prognosis (HR: 2.82, 95% CI: 1.01-7.84; p = 0.047). Protein expression of YKL-40 in ASC tumor cells was significantly associated with low tumor grade (p = 0.031), while the increased expression in peritumor immune cells was associated with a worse response of patients to chemoradiotherapy (p = 0.007). However, YKL-40 protein expression in ASC tumor cells or peritumor immune cells did not significantly impact patient overall survival.
UNASSIGNED: In conclusion, YKL-40 resulted a relevant prognostic (serum level) and predictive (tissue protein expression in peritumor immune cells) biomarker and can considerably improve ASC patient clinical management.
UNASSIGNED: We retrospectively retrieved 72 consecutive cases of ASC diagnosed between February 2011 and March 2021. Both serum and tissue protein expression of YKL-40 were assessed, the latter in ASC tumor cells and peritumor immune cells.
UNASSIGNED: Increased YKL-40 serum levels at the time of diagnosis were associated with older age (p = 0.035), presence of cardiovascular/metabolic comorbidities (p = 0.007), and death for any cause (p = 0.011). In addition, high serum levels of YKL-40 were associated with a poor prognosis (HR: 2.82, 95% CI: 1.01-7.84; p = 0.047). Protein expression of YKL-40 in ASC tumor cells was significantly associated with low tumor grade (p = 0.031), while the increased expression in peritumor immune cells was associated with a worse response of patients to chemoradiotherapy (p = 0.007). However, YKL-40 protein expression in ASC tumor cells or peritumor immune cells did not significantly impact patient overall survival.
UNASSIGNED: In conclusion, YKL-40 resulted a relevant prognostic (serum level) and predictive (tissue protein expression in peritumor immune cells) biomarker and can considerably improve ASC patient clinical management.
摘要：
■肛门鳞状细胞癌（ASC）是一种罕见的胃肠道恶性肿瘤，在过去几十年中发病率有所增加。YKL-40是一种免疫调节剂和促血管生成因子，在几种恶性肿瘤中显示出有希望的预后和预测潜力。但ASC的可用数据有限。本研究旨在广泛评估YKL-40在ASC患者的多中心队列中的预后和预测作用。
■我们回顾性检索了2011年2月至2021年3月期间诊断的72例连续ASC病例。检测血清和组织中YKL-40蛋白的表达,后者在ASC肿瘤细胞和瘤周免疫细胞中。
■诊断时血清YKL-40水平升高与年龄增长有关（p=0.035），心血管/代谢合并症的存在（p=0.007），和任何原因的死亡（p=0.011）。此外,血清YKL-40水平升高与预后不良相关(HR:2.82,95%CI:1.01-7.84;p=0.047).YKL-40在ASC肿瘤细胞中的蛋白表达与低肿瘤分级显著相关(p=0.031),而肿瘤周围免疫细胞的表达增加与患者对放化疗的反应较差相关(p=0.007)。然而,ASC肿瘤细胞或肿瘤周围免疫细胞中的YKL-40蛋白表达对患者总生存期没有显著影响。
■总而言之，YKL-40产生相关的预后（血清水平）和预测性（肿瘤周围免疫细胞中的组织蛋白表达）生物标志物，并且可以显着改善ASC患者的临床管理。
■我们回顾性检索了2011年2月至2021年3月期间诊断的72例连续ASC病例。检测血清和组织中YKL-40蛋白的表达,后者在ASC肿瘤细胞和瘤周免疫细胞中。
■诊断时血清YKL-40水平升高与年龄增长有关（p=0.035），心血管/代谢合并症的存在（p=0.007），和任何原因的死亡（p=0.011）。此外,血清YKL-40水平升高与预后不良相关(HR:2.82,95%CI:1.01-7.84;p=0.047).YKL-40在ASC肿瘤细胞中的蛋白表达与低肿瘤分级显著相关(p=0.031),而肿瘤周围免疫细胞的表达增加与患者对放化疗的反应较差相关(p=0.007)。然而,ASC肿瘤细胞或肿瘤周围免疫细胞中的YKL-40蛋白表达对患者总生存期没有显著影响。
■总而言之，YKL-40产生相关的预后（血清水平）和预测性（肿瘤周围免疫细胞中的组织蛋白表达）生物标志物，并且可以显着改善ASC患者的临床管理。
