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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 investigate the expression of Yes-associated protein (YAP) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological features and alpha-fetal protein (AFP) The significance of diagnosis. Methods Immunohistochemistry was used to detect the expression of YAP in 52 patients with hepatocellular carcinoma (HCC) and 43 adjacent normal liver tissues (control group). Western blot was used to detect the expression of YAP in 25 patients with hepatocellular carcinoma (HCC) And 26 normal subjects (normal group). The diagnostic test was used to evaluate the value of YAP protein alone and combined with AFP in the diagnosis of hepatocellular carcinoma. Results (1) The positive rate of YAP expression in the observation group was 80.77%, the control group was 9.30%, the difference between the two groups was statistically significant (P <0.01); (2) The positive expression of YAP in the observation group was significantly different between gender, age, tumor diameter, (P> 0.05), but there was no significant difference between the two groups (P> 0.05). (3) The positive degree of YAP in the observation group was positively correlated with the serum AFP level (4) The relative expression of serum YAP protein in HCC group (0.629 2 ± 0.065 9) was higher than that in the normal group (0.020 ± 0.034 0) (P <0.05) The sensitivity (92.0%) of the combined detection of protein + AFP was higher than that of YAP alone (72.0%) and AFP alone (64.0%) (P <0.05) The specificity of YAP (96.2%) and AFP (88.5%) was no significant difference (P> 0.05). Conclusion YAP plays an important role in the occurrence and development of hepatocellular carcinoma. Combined detection of serum YAP protein and AFP can improve the diagnostic rate of hepatocellular carcinoma. YAP can be used as one of the reliable serological markers for hepatocellular carcinoma screening, detection and follow-up.