Evaluation of pleural fluid YKL-40 as a marker of malignant pleural effusion

• Published in: Egyptian Journal of Chest Disease and Tuberculosis
• Main Authors: Adel Attia, Ayman Rasmy, Amal Amin, Manal Alanazi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-04-01
• Subjects: YKL-40; Pleural effusion; Malignant pleural effusion
• Online Access: http://www.sciencedirect.com/science/article/pii/S0422763814200835
• ISSN: 0422-7638

The glycoprotein YKL-40 is synthesized both by cancer cells and by tumor-associated macrophages and plays a functional role in tumor progression. Consequently, high serum YKL-40 levels have been associated with a poor prognosis in patients with several cancer types. The aim of this study is to assess pleural effusion and serum concentrations of YKL-40 in patients with different types of pleural effusions and to evaluate the diagnostic performance of YKL-40 in detecting malignant pleural effusion. Patients and methods: A prospective cohort study was carried out of 88 consecutive patients presenting with pleural effusions. The patients were divided into four groups: 22 patients with transudative effusions, 24 patients with parapneumonic pleural effusion and 8 patients with tuberculous pleural effusion and 34 patients with malignant pleural effusions. Blood and pleural fluid YKL-40 levels were measured using enzyme-linked immunosorbent assay. Results: Both serum HE4 levels and pleural effusion YKL-40 levels were significantly higher in patients with malignant effusions than in patients with transudative or non-malignant exudative effusions. A pleural fluid YKL-40 cut-off value of 256 ng/mL was found to predict malignant pleural effusions with a diagnostic sensitivity of 85.3% and specificity of 90.7%. Conclusion: The current study reports a finding of increased serum and pleural fluid YKL-40 levels in patients with malignant pleural effusions compared to non-malignant effusions.