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To investigate clinical significance of YKL-40 in hepatocellular carcinoma (HCC) patients with hepatitis B (HBV) related cirrhosis.    Material and methods  The present prospective observational study included 129 cases of HCC patients. Besides, 152 patients with only hepatitis B related cirrhosis and 110 HCC patients with no cirrhosis were also enrolled during the same period. Additionally, 100 healthy individuals were enrolled as control. Serum YKL-40 levels were determined using ELISA method. Levels of serum albumin, total bilirubin, alanine aminotransferase (ALT) and aspartate transaminase (AST) as well as HCC related biomarkers of alpha fetoprotein (AFP), des-γ-carboxy prothrombin (DCP), gamma glutamyltransferase (GCT-II), α-L-Fucosidase (AFU), CEA and CA19-9 were measured using an automatic biochemical analyzer. Patients’ demographic and clinical characteristics were collected and analyzed.    Results  The expression of YKL-40 was the highest in HCC patients with HBV-related cirrhosis and the lowest in the healthy control, and the difference was significant compared with other groups. And HCC patients showed markedly higher YKL-40 levels than the HBV-related cirrhosis patients. Patients with higher expression of YKL-40 showed higher ratio of TNM IV, lymphatic metastasis and Child-Pugh C, and higher serum levels of AFP, AFU and CA19-9 than those in the patients with lower levels of YKL-40. YKL-40 level was positively correlated with AFP and AFU. Survival analysis showed patients with higher expression of YKL-40 had shorter 1-year survival time than the patients with lower YKL-40.    Conclusions  YKL-40 was elevated in HCC patients with HBV-related cirrhosis and high expression of YKL-40 predicted poor prognosis and shorter 1-year survival.

Up-regulated YKL-40 is associated with poor prognosis of HCC patients with hepatitis B related cirrhosis