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Open Access Research article

Y-box protein-1/p18 fragment identifies malignancies in patients with chronic liver disease

Frank Tacke1, Nicolas Kanig12, Abdelaziz En-Nia2, Thilo Kaehne3, Christiane S Eberhardt2, Victoria Shpacovitch2, Christian Trautwein1 and Peter R Mertens2*

Author Affiliations

1 Department of Medicine III, University Hospital Aachen, RWTH-Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany

2 Nephrology and Hypertension & Endocrinology and Metabolic Disease, Otto-von-Guericke University Magdeburg, Leipziger Str. 40, 39120 Magdeburg, Germany

3 Institute of Experimental Internal Medicine, Otto-von-Guericke University Magdeburg, Leipziger Str. 40, 39120 Magdeburg, Germany

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BMC Cancer 2011, 11:185  doi:10.1186/1471-2407-11-185

Published: 20 May 2011

Abstract

Background

Immunohistochemical detection of cold shock proteins is predictive for deleterious outcome in various malignant diseases. We recently described active secretion of a family member, denoted Y-box (YB) protein-1. We tested the clinical and diagnostic value of YB-1 protein fragment p18 (YB-1/p18) detection in blood for malignant diseases.

Methods

We used a novel monoclonal anti-YB-1 antibody to detect YB-1/p18 by immunoblotting in plasma samples of healthy volunteers (n = 33), patients with non-cancerous, mostly inflammatory diseases (n = 60), hepatocellular carcinoma (HCC; n = 25) and advanced solid tumors (n = 20). YB-1/p18 was then tested in 111 patients with chronic liver diseases, alongside established tumor markers and various diagnostic measures, during evaluation for potential liver transplantation.

Results

We developed a novel immunoblot to detect the 18 kD fragment of secreted YB-1 in human plasma (YB-1/p18) that contains the cold-shock domains (CSD) 1-3 of the full-length protein. YB-1/p18 was detected in 11/25 HCC and 16/20 advanced carcinomas compared to 0/33 healthy volunteers and 10/60 patients with non-cancerous diseases. In 111 patients with chronic liver disease, YB-1/p18 was detected in 20 samples. Its occurrence was not associated with advanced Child stages of liver cirrhosis or liver function. In this cohort, YB-1/p18 was not a good marker for HCC, but proved most powerful in detecting malignancies other than HCC (60% positive) with a lower rate of false-positive results compared to established tumor markers. Alpha-fetoprotein (AFP) was most sensitive in detecting HCC, but simultaneous assessment of AFP, CA19-9 and YB-1/p18 improved overall identification of HCC patients.

Conclusions

Plasma YB-1/p18 can identify patients with malignancies, independent of acute inflammation, renal impairment or liver dysfunction. The detection of YB-1/p18 in human plasma may have potential as a tumor marker for screening of high-risk populations, e.g. before organ transplantation, and should therefore be evaluated in larger prospective studies.

Keywords:
cold shock proteins; liver transplantation; hepatocellular carcinoma; cancer screening; serum markers