Impact of tumor size on the prognosis of hepatocellular carcinoma in patients who underwent liver resection

Dai, Chia‐Yen; Lin, Chung‐Sheng; Tsai, Pei‐Chien; Lin, Ping‐Yi; Yeh, Ming‐Lun; Huang, Chung‐Feng; Chang, Wen Tsan; Huang, Jee‐Fu; Yu, Ming‐Lung; Chen, Yao‐Li

doi:10.1016/j.jcma.2017.06.018

Cited by 44 publications

(41 citation statements)

References 39 publications

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“…However, we extended the observation to the post-operative follow-up period. We identified that tumor size may determine early HCC recurrence, which was in line with previous report 17 . Imperatively, we demonstrated that low MICA levels in the cancer tissue may play a critical biological role.…”

Section: Discussionsupporting

confidence: 92%

“…A stepwise logistic regression analysis was performed to evaluate the independent factors associated with high levels of MICA expression in the tumor tissue. To avoid the issue of incomplete resection, patients with recurrent HCC within six months after surgery were excluded when judging the factors predictive of HCC recurrence 17 . Kaplan–Meier analysis and the log-rank test were performed by comparing the differences in HCC recurrence between the determining factors.…”

Section: Methodsmentioning

confidence: 99%

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Lower protein expression levels of MHC class I chain-related gene A in hepatocellular carcinoma are at high risk of recurrence after surgical resection

Huang

Wang

Yeh

et al. 2018

Sci Rep

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MHC class I chain-related gene A (MICA) variants have been associated with hepatocellular carcinoma (HCC). Their association with MICA expression in cancer cells and cancer recurrence is unknown. SNP rs2596542 of MICA was tested in 193 HCC patients with surgical resection. The corresponding MICA expression in the cancer tissue was measured by immunochemistry microarray. Patients with the SNP rs2596542 A allele had significantly lower MICA expression in tumor tissue than did those with the GG genotype (24.7 ± 15.1% vs. 41.5 ± 23.4%, P < 0.001). Patients who had HCC recurrence had significantly lower MICA expression in tumor tissue (34.2 ± 21.8% vs. 24.0 ± 19.8%, P = 0.03). Cox regression analysis revealed that the factors independently predictive of HCC recurrence included low MICA expression (hazard ratio [HR]/95%confidence intervals [CI]: 2.77/1.07–7.14, P = 0.035) and tumor size (HR/CI: 5.22/2.11–12.96, P < 0.001). Compared to patients with tumors <5 cm and MICA expression >30%, patients with either one and both two risk factors had HCC HRs of 9.76 (C.I. 1.27–75.03, P = 0.03) and 27.30 (C.I. 3.46–215.6, P = 0.002), respectively. We concluded that low cellular MICA expressions were at a greater risk of HCC recurrence after curative treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Lower protein expression levels of MHC class I chain-related gene A in hepatocellular carcinoma are at high risk of recurrence after surgical resection

Huang

Wang

Yeh

et al. 2018

Sci Rep

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“…In Cox regression analyses, EXO1 expression was (univariate) or tended to be (multivariate) an independent risk factor, while gender and tumor size were definite independent risk factors. As a widely used marker for routine surveillance and noninvasive diagnosis of HCC, high serum AFP levels (≥ 20µg/L) play an important role in predicting high mortality among patients with tumor size ≥ 5 cm [36]. However, prognostic markers for patients with no AFP expression (< 20µg/L) are rare.…”

Section: Discussionmentioning

confidence: 99%

EXO1 overexpression is associated with poor prognosis of hepatocellular carcinoma patients

et al. 2018

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The roles of exonuclease 1 (EXO1) in hepatocellular carcinoma (HCC) tumorigenesis and progression remain unclear. This study aimed to assess the prognostic value and therapeutic potential of EXO1 in HCC. Exo1 gene copy numbers were obtained from three Oncomine microarray datasets (n = 447). EXO1 mRNA expression was validated by semi-quantitative PCR and QuantiGene® 2.0 assays. Cell growth curve and colony formation were performed to asses the cell proliferation. Clonogenic assay, flow cytometry, and immunofluorescence were adopted to acess the effects of EXO1 knockdown and radiation on cell survival, cell cycle distribution and DNA repair. Western blots were performed to reveal the related mechanism. A significant copy number variation (CNV) of the Exo1 gene was found in HCC specimens in three separate sets of published microarray data. In the 143 cases treated by our team, EXO1 expression levels were elevated (86.71%, 124/143). In addition, EXO1 overexpression was correlated with larger tumor size (P = 0.002), increased lymph node metastasis (P=0.033) and lower Edmondson grade (P = 0.018). High EXO1 expression unfavorably affected overall survival (OS) (P = 0.009). Both univariate and multivariate Cox regression analyses identified EXO1 as an independent predictor of OS (univariate, P = 0.012; multivariate, P = 0.039). Silencing of EXO1 in vitro reduced cell proliferation. EXO1 knockdown further suppressed clonogenic cell survival, abrogated radiation-induced G2/M phase arrest, and enhanced γ-H2AX foci after exposure to irradiation. The accumulation of ataxiatelangiectasia mutated (ATM) might partially regulate the EXO1 related radiosensitivity. In summary, EXO1 could be a promising prognostic marker, with a potential therapeutic value in HCC.

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“…Production of AFP in tumors us often found in the germ cell tumors, particularly yolk sac tumor [ 4 , 5 ]. AFP is also secreted in other tumors such as hepatocellular carcinoma and testicular carcinoma [ 6 ]. Epithelial ovarian cancers had been rarely reported to secrete AFP [ 7 , 8 ], and AFP-producing EOCs are also extremely rare.…”

Section: Discussionmentioning

confidence: 99%

Alpha-fetoprotein-producing ovarian clear cell adenocarcinoma with fetal gut differentiation: a rare case report and literature review

et al. 2018

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BackgroundAlpha-fetoprotein (AFP) is a useful tumor marker for ovarian germ cell tumors, particularly yolk sac tumor (YST). It is valuable for both diagnosis and further follow-up. Epithelial ovarian carcinoma (EOC) rarely secretes AFP, especially for clear cell type and in the postmenopausal women. Based on the limited knowledge about AFP-producing clear cell type EOC, a case and literature review on this topic is extensively reviewed.Case presentationWe report a 55-year-old postmenopausal woman experienced vaginal spotting for one month, and serum level of AFP was 60,721 ng/ml initially. Histological examination was clear cell type EOC. Tumor cells revealed strong immunoreactivity for glypican-3 (GPC3) and AFP and weak for hepatocyte nuclear factor-1 beta (HNF-1 beta), but negative for CD30, making the diagnosis of AFP-producing clear cell type EOC with fetal gut differentiation in focal areas, FIGO (International Federation of Gynecology and Obstetrics) IIIc. Although the patient underwent an intensive treatment, including optimal debulking surgery and multi-agent chemotherapy, the patient died of disease. To provide a better understanding of clinical and molecular characteristics of the AFP-producing clear cell type EOC, we conducted a systematic literature review.ConclusionsA total of three papers described the AFP-producing clear cell type EOC are available. The overall survival rate of these cases, including the current case is 50%. Although immunohistochemical examination is not always needed in routine for the diagnosis of clear cell type EOC, to distinguish from other tumors, especially germ cell tumors, or to provide the better way to monitor therapeutic response or to evaluate the disease status, immunostaining, including GPC3, HNF-1 beta, CD30, cytokeratin 7 or 20, and AFP is taken into account. Due to rarity, the appropriate chemotherapy regimen and the biological behavior of AFP-producing clear cell type EOC are still unclear.

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Impact of tumor size on the prognosis of hepatocellular carcinoma in patients who underwent liver resection

Abstract: Tumor size ≥5 cm might be a good predicting factor for death and early recurrence when considering death as a competing risk.

Cited by 44 publications

References 39 publications

Lower protein expression levels of MHC class I chain-related gene A in hepatocellular carcinoma are at high risk of recurrence after surgical resection

Lower protein expression levels of MHC class I chain-related gene A in hepatocellular carcinoma are at high risk of recurrence after surgical resection

EXO1 overexpression is associated with poor prognosis of hepatocellular carcinoma patients

Alpha-fetoprotein-producing ovarian clear cell adenocarcinoma with fetal gut differentiation: a rare case report and literature review

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