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OBJECTIVE: In this study, we examined the relationships between the expression level of CHI3L1 and the clinicopathological characteristics of papillary thyroid carcinoma. METHODS: A total of 322 tissue samples from patients with papillary thyroid carcinoma were collected, and the CHI3L1 expression levels in tumor tissues, matched adjacent noncancerous tissues were detected using immunohistochemistry (IHC) and qRT-PCR. The relationships between CHI3L1 expression levels and the clinical characteristics were evaluated. RESULTS: CHI3L1 expression was significantly increased in papillary thyroid carcinoma compared with matched adjacent noncancerous tissues (P <0.001), tumor tissues with lymph node metastasis (LNM) compared with tumor tissues without LNM (P <0.001) and tumor tissues with distant organ metastasis (DOM) compared with tumor tissues without DOM (P <0.01). CHI3L1 expression was significantly associated with tumor size (P = 0.0001), lymph node metastasis (P <0.0001), distant organ metastasis (P < 0.0001), extrathyroid invasion (P = 0.0022), vascular invasion (P = 0.0004) and TNM stage (P = 0.0001). CHI3L1 overexpression in papillary thyroid carcinoma tissues correlates with the tumor malignant potential (P <0.01). More importantly, Cox multifactor analysis indicated that patients with high CHI3L1 expression have lower overall survival, disease-free survival, lymph node recurrence-free survival, and distant recurrence free survival rates than those with low expression (P <0.05). And our findings were further validated by online Oncomine database. CONCLUSIONS: CHI3L1 is associated with tumor metastasis and might be a prognostic biomarker for papillary thyroid carcinoma. [ABSTRACT FROM AUTHOR]