Eda ADİVİYE ŞAHİN, Burak SEZGİN, Hanifi ŞAHİN, Oğuzhan ÖZCAN, Oya SOYLU KARAPINAR, İlkay GÖZÜKARA, Arif GÖNGÖREN

YKL-40 and fibronectin levels in patients with placentalinvasion anomaly

Aim: To investigate the level of YKL-40 and fibronectin in patients with total placenta previa and to evaluate the presence of placental invasion anomaly such as accreta.Materials and Methods: A total of 60 patients were included in this prospective study. The patients were classified according to the placental localization as assessed through ultrasound. The study group consisted of 33 patients diagnosed with placenta previa or accreta with previous cesarean section. These patients were also subdivided into two groups according to the histopathological examination results as invasion-positive group and invasion-negative group. The control group consisted of 27 patients who were admitted to the gynecology clinic with previous cesarean deliveries and had normal placental localization. Serum YKL-40 and fibronectin levels were measured in two groups via human chitinase-3-like protein 1 (Ykl-40/CHI3L1) and fibronectin enzyme-linked immunosorbent assay kits.Results: Mean serum levels for YKL-40 and fibronectin were similar between the study and control groups. In the subgroup analysis according to invasion anomaly, the level of YKL-40 in invasion-positive group (n=11) was higher than invasion-negative group (n=22), indicating a statistically significant difference.Conclusion: Outcomes of this research indicates that YKL-40 can be used as a marker for identifying placental invasion anomalies.

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1. Cresswell JA, Ronsmans C, Calvert C, et al. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health 2013;18:712-24.
2. Silver RM. Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta. Obstet Gynecol 2015;126:654-68.
3. Stanek J, Drummond Z. Occult placenta accreta: the missing link in the diagnosis of abnormal placentation. Pediatr Dev Pathol 2007;10:266-73.
4. Abuhamad A. Morbidly adherent placenta. Semin Perinatol 2013;37:359-64.
5. Morlando M, Sarno L, Napolitano R, et al. Placenta accreta: incidence and risk factors in an area with a particularly high rate of cesarean section. Acta Obstet Gynecol Scand 2013;92:457-60.
6. Silver RM, Barbour KD. Placenta accreta spectrum: accreta, increta, and percreta. Obstet Gynecol Clin North Am 2015;42:381-402.
7. Baker AM, Braun JM, Salafia CM, et al. Risk factors for uteroplacental vascular compromise and inflammation. Am J Obstet Gynecol 2008;199:256 e1- 9.
8. Biberoglu E, Kirbas A, Daglar K, et al. Serum angiogenic profile in abnormal placentation. J Matern Fetal Neonatal Med 2016;29:3193-7.
9. Lee CG, Da Silva CA, Dela Cruz CS, et al. Role of chitin and chitinase/chitinase-like proteins in inflammation, tissue remodeling, and injury. Annu Rev Physiol 2011;73:479-501.
10. Johansen JS, Schultz NA, Jensen BV. Plasma YKL40: a potential new cancer biomarker? Future Oncol 2009;5:1065-82.
11. Eurich K, Segawa M, Toei-Shimizu S, et al. Potential role of chitinase 3-like-1 in inflammation-associated carcinogenic changes of epithelial cells. World J Gastroenterol 2009;15:5249-59.
12. Hoover DJ, Zhu V, Chen R, et al. Expression of the chitinase family glycoprotein YKL-40 in undifferentiated, differentiated and transdifferentiated mesenchymal stem cells. PLoS One 2013;e62491.
13. Gybel-Brask D, Johansen JS, Christiansen IJ, et al. Serum YKL-40 and gestational diabetes - an observational cohort study. APMIS 2016;124:770-5.
14. Kucur M, Tuten A, Oncul M, et al. Maternal serum apelin and YKL-40 levels in early and late-onset preeclampsia. Hypertens Pregnancy 2014;33:467-75.
15. Kaloglu C, Onarlioglu B. Extracellular matrix remodelling in rat endometrium during early pregnancy: the role of fibronectin and laminin. Tissue Cell 2010;42:301-6.
16. Guillomot M, Campion E, Prezelin A, et al. Spatial and temporal changes of decorin, type I collagen and fibronectin expression in normal and clone bovine placenta. Placenta 2014;35:737-47.
17. Kauma S, Clark MR, White C, et al. Production of fibronectin by peritoneal macrophages and concentration of fibronectin in peritoneal fluid from patients with or without endometriosis. Obstet Gynecol 1988;72:13-8.
18. Sherer DM, Salafia CM, Minior VK, et al. Placental basal plate myometrial fibers: clinical correlations of abnormally deep trophoblast invasion. Obstet Gynecol 1996;87:444-9.
19. Ernst LM, Linn RL, Minturn L, et al. Placental Pathologic Associations With Morbidly Adherent Placenta: Potential Insights Into Pathogenesis. Pediatr Dev Pathol 2017;20:387-93.
20. Linn RL, Miller ES, Lim G, et al. Adherent basal plate myometrial fibers in the delivered placenta as a risk factor for development of subsequent placenta accreta. Placenta 2015;36:1419-24.
21. Lorenz RP. What is new in placenta accreta?: best articles from the past year. Obstet Gynecol 2013;121:375-6.
22. Amsalem H, Kingdom JCP, Farine D, et al. Planned caesarean hysterectomy versus "conserving" caesarean section in patients with placenta accreta. J Obstet Gynaecol Can 2011;33:1005-10.
23. Ersoy AO, Oztas E, Ozler S, et al. Can venous ProBNP levels predict placenta accreta? J Matern Fetal Neonatal Med 2016;29:4020-4.
24. Zhou J, Li J, Yan P, et al. Maternal plasma levels of cell-free beta-HCG mRNA as a prenatal diagnostic indicator of placenta accrete. Placenta 2014;35:691- 5.
25. Kemik P, Saatli B, Yildirim N, et al. Diagnostic and prognostic values of preoperative serum levels of YKL-40, HE-4 and DKK-3 in endometrial cancer. Gynecol Oncol 2016;140:64-9.
26. Zou L, He X, Zhang JW. The efficacy of YKL-40 and CA125 as biomarkers for epithelial ovarian cancer. Braz J Med Biol Res 2010;43:1232-8.
27. Fan JT, Si XH, Liao Y, et al. The diagnostic and prognostic value of serum YKL-40 in endometrial cancer. Arch Gynecol Obstet 2013;287:111-5.
28. Peng C, Peng J, Jiang L, et al. YKL-40 protein levels and clinical outcome of human endometrial cancer. J Int Med Res 2010;38:1448-57.
29. Seol HJ, Lee ES, Jung SE, et al. Serum levels of YKL40 and interleukin-18 and their relationship to disease severity in patients with preeclampsia. J Reprod Immunol 2009;79:183-7.
30. Bodova KB, Biringer K, Dokus K, et al. Fibronectin, plasminogen activator inhibitor type 1 (PAI-1) and uterine artery Doppler velocimetry as markers of preeclampsia. Dis Markers 2011;30:191-6.