Diagnostic potential of YKL-40 in bladder cancer.

Abstract Objectives YKL-40 is a glycoprotein, which is thought to play a role in inflammatory conditions and tissue remodeling. Although it has been investigated in numerous cancers, there is very limited knowledge about the role of YKL-40 in bladder cancer. In this study, our aim was to determine the levels of YKL-40 in the sera and urines of the patients with bladder cancer, and compare it to urinary bladder tumor antigen (BTA), a tumor marker that can be used in the diagnosis of bladder cancer. Methods The study was comprised of 2 major groups as 65 healthy controls and 67 patients with bladder cancer. The patient group was also divided into subgroups according to tumor stage and grade. Serum and urine YKL-40 levels and urine BTA levels in controls and patients were determined using commercially available enzyme-linked immunosorbent assay kits. Results Serum YKL-40 and urinary BTA levels were significantly elevated in patients and all patient subgroups compared to healthy controls. Urine YKL-40 levels, on the other hand, were significantly elevated in all subgroups except low stage (Ta) and low grade, compared to controls. Although serum YKL-40 levels could not differentiate any subgroup from one another, urinary BTA could only differentiate low stage (Ta) from all invasive (T1–T4) cancers. However, urine YKL-40 levels were significantly elevated in all invasive subgroups (T1, T2–T4, and T1–T4), compared to low stage (Ta). Conclusions In summary, urine YKL-40 levels can be used to assist BTA in the diagnosis of bladder cancer as a marker for early invasiveness and thus help determine its treatment regimen.