Yes相关蛋白在人肝细胞肝癌中表达及意义

Expression of Yes-associated protein in human hepatocellular carcinoma and its clinical significance

目的探讨Yes相关蛋白(Yes-associated protein,YAP)在肝细胞肝癌组织中的表达,以及其与临床病理特征、甲胎蛋白(alpha-fetal protein,AFP)的关系,评价其在肝细胞肝癌早期诊断中的意义。方法应用免疫组织化学方法检测52例肝细胞肝癌患者手术切除肝癌组织(观察组),43份癌旁正常肝组织(对照组)YAP表达情况;应用Western blot法检测25例肝癌患者(肝癌组)和26例正常人(正常组)血清YAP蛋白;应用诊断试验评价YAP蛋白单独及其联合AFP诊断肝细胞肝癌的价值。结果 (1)观察组YAP表达阳性率为80.77%,对照组为9.30%,2组比较差异有统计学意义(P<0.01);(2)观察组YAP阳性表达在性别、年龄、肿瘤直径、有无静脉侵犯和肿瘤分期上差异无统计学意义(P>0.05),而在肿瘤分化程度上差异有统计学意义(P<0.05);(3)观察组YAP阳性程度与患者血清AFP水平呈正相关(r=0.536,P=0.001);(4)肝癌组血清YAP蛋白相对表达量(0.629 2±0.065 9)高于正常组(0.020 0±0.034 0)(P<0.05);(5)YAP蛋白+AFP联合检测的灵敏度(92.0%)高于单独YAP(72.0%)和单独AFP(64.0%)检测的灵敏度(P<0.05);YAP蛋白+AFP联合检测的特异度(92.3%)与单独YAP(96.2%)、AFP(88.5%)检测的特异度比较差异无统计学意义(P>0.05)。结论 YAP在肝细胞肝癌发生、发展中起重要作用;联合检测血清YAP蛋白和AFP可提高肝细胞肝癌诊断率;YAP可作为肝细胞肝癌筛选、检测和随访的可靠血清学指标之一。

Objective To evaluate the significance of Yes-associated protein（YAP）in the early diagnosis of hepatocellular carcinoma（HCC）by exploring the expression of YAP in HCC and its correlation with alpha-fetal protein（AFP）and clinicopathological features.Methods The expression of YAP was detected by immunohistochemistry in 52 cases of HCC tissues（observation group）and 43 cases of adjacent normal tissues（control group）.The expression of serum YAP protein was detected by Western blot in 25 cases of HCC patients（HCC group）and 26 normal controls（normal group）.The value of YAP protein and/or AFP for HCC was evaluated by diagnostic value test.Results The positive rate of YAP expression was 80.77% in observation group,significantly different from that in control group（9.30%）（P〈0.01）.The positive expression of YAP was correlated with tumor differentiation degree（P〈0.05）,and not correlated with gender,age,tumor diameter,venous invasion,or TNM stages of HCC（P〉0.05）.The degree of positive expression of YAP was positively correlated with the serum level of AFP（r=0.536,P=0.001）.The relative expression level of YAP in HCC group（0.629 2±0.065 9）was significantly higher than that in normal group（0.020 9±0.034 0）（P〈0.05）.The sensitivity of YAP and AFP joint detection was 92.0%,higher than that of single YAP detection（72.0%）or single AFP detection（64.0%）（P〈0.05）.There were no significant differences in the sensitivities among YAP and AFP joint detection（92.3%）,single AFP detection（96.2%）and single YAP detection（88.5%）（P〉0.05）.Conclusion YAP plays an important role in the occurrence and development of HCC.Joint detection of YAP and AFP can improve the diagnostic rate of HCC.YAP is one of reliable serological indexes in the screening,detection and follow-up survey of HCC.