Development Of A Chemiluminescence Immunoassay For Serum Yb-1 And Its Clinical Application As A Potential Diagnostic Marker For Hepatocellular Carcinoma

Background: Y-box binding protein 1 (YB-1) overexpression has been shown in various tumor cells including hepatocellular carcinoma (HCC); moreover, this protein can be actively secreted.Objectives: The aim of this study was to establish a method to quantify serum YB-1 and evaluate its clinical application in the clinical diagnosis of HCC.Patients and Methods: Recombinant YB-1 and two populations of its antibodies were prepared. A monoclonal antibody was specific to the N-terminus of YB-1 amino acids 134-160; and another was a polyclonal antibody. A sandwich-type chemiluminescence immunoassay (CLIA) was developed and evaluated. Levels of YB-1 and alpha fetoprotein (AFP) in serum samples from 105 HCC patients, 25 hepatitis B virus patients, 25 cirrhosis patients, and 50 healthy donors were detected using the established method and an AFP electrochemiluminescence kit.Results: The developed method was linear to 150 mu g/L of YB-1 with a minimum detection limit of 0.01 mu g/L. The average recoveries were between 93.9% and 109.0%. The mean intra- and inter-assay coefficients of variation (CVs) were 4.0-4.8% and 8.2-10.2%, respectively. The relationship between the concentration of diluted YB-1 and the dilution ratios gave a good linear correlation coefficient of 0.9986. The YB-1 concentration was increased in serum of HCC patients (33.0 +/- 23.39 mu g/L) compared to healthy individuals (13.2 +/- 5.29 mu g/L, P < 0.0001), patients with HBV (17.9 +/- 7.49 mu g/L, P = 0.0003), and patients with HBV cirrhosis (20.7 +/- 8.75 mu g/L, P < 0.05). Moreover, the combination of YB-1 and alpha-fetoprotein had a high sensitivity (89.5%) and reasonable specificity (62.0%) in identifying HCC.Conclusions: The established method has an acceptable performance in quantifying YB-1. In addition, serum YB-1 may aid in the diagnosis of HCC.