The expression and clinical significance of YAP1 in locally advanced oral squamous cell carcinoma

BAI Xin; ZHAO Yadong; GAO Liping; WU Surina

doi:10.3969/j.issn.1009-0460.2023.10.002

Abstract：Objective To investigate the significance of Yes associated protein 1(YAP1)in evaluating the efficacy of neoadjuvant synchronous radiotherapy and chemotherapy(CCRT)in locally advanced oral squamous cell carcinoma(LAOSCC).Methods One hundred and nine LAOSCC patients and 83 healthy volunteers(control group)who underwent neoadjuvant CCRT treatment after surgical resection in our hospital from February 2016 to June 2018 were collected.Immunohistochemical(IHC)staining was used to detect the expression of YAP1 protein,and real-time quantitative PCR(qPCR)was used to detect the relative expression of YAP1 mRNA in saliva.Evaluate the efficacy and divide it into CR,PR,SD,and PD.CR+PR is defined as treatment response,SD+PD is defined as treatment without response.Follow up the total survival time(OS)of patients.Results Among 109 LAOSCC patients,21 were CR,52 were PR,13 were PD,and 23 were SD.The YAP1 protein score of patients in the remission group was significantly lower than that of patients in the non remission group[108.53(89.82,128.21)vs.134.65(103.71,144.57),P＜0.05].ROC curve analysis showed that the AUC of YAP1 protein score for predicting the efficacy of neoadjuvant CCRT was 0.806(95%CI:0.711-0.900),with an optimal cutoff value of 131.21 points.The expression of YAP1 protein is related to staging and survival(P＜0.05),but not to any other factors.Compared with the control group,the relative expression of YAP1 mRNA in baseline saliva of patients in the LAOSCC group was generally higher[1.04(0.72,1.14)vs.1.30(1.01,1.70),P＜0.001].Logistic regression analysis showed that only YAP1 protein score was an independent factor affecting the efficacy of neoadjuvant CCRT(P＜0.05).Compared with baseline values,the relative expression of YAP1 mRNA in saliva decreased in the remission group,while it increased in the non remission group.The relative expression of YAP1 mRNA in baseline saliva was positively correlated with the IHC score of YAP1 protein(rs=0.245,P=0.010).The median OS of patients with low expression of YAP1 protein was 58 months(14-60 months),while those with high expression were 24 months(8.5-63 months),with a statistically significant difference(P = 0.018).Conclusion The high score of tissue YAP1 protein IHC is associated with no response and low OS in LAOSCC patients treated with neoadjuvant CCRT.The relative expression of saliva YAP1 mRNA is also associated with the occurrence of LAOSCC and the response to neoadjuvant CCRT treatment.