title: Y-box protein-1/p18 fragment identifies malignancies in patients with chronic liver disease.
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.
authors: Department of Medicine III, University Hospital Aachen, RWTH-Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
authors: Frank
authors: F
authors: Tacke
authors: Nicolas
authors: N
authors: Kanig
authors: Abdelaziz
authors: A
authors: En-Nia
authors: Thilo
authors: T
authors: Kaehne
authors: Christiane S
authors: CS
authors: Eberhardt
authors: Victoria
authors: V
authors: Shpacovitch
authors: Christian
authors: C
authors: Trautwein
authors: Peter R
authors: PR
authors: Mertens
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