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Hepatocyte nuclear factor 1β is a novel prognostic marker independent of the milan criteria in transplantable hepatocellular carcinoma: A retrospective analysis based on tissue microarrays.
MedLine Citation:
PMID:  23203386     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: We retrospectively investigated the prognostic value of hepatocyte nuclear factor-1 (HNF1) proteins in 159 liver transplant patients with hepatocellular carcinomas (HCC), including 36 (22.6%) exceeding the Milan criteria. METHODS: Expression of alpha-fetoprotein (AFP), HNF1α, and HNF1β was examined by immunohistochemistry on duplicate tissue microarray slides containing the HCC tumor explants. Times to recurrence and cancer death were analyzed based on the Cox regression model and compared according to expression of markers of interest. We compared risk predictions using area under the receiver operator curves (AU-ROCs) and c statistics. RESULTS: AFP, HNF1α, and HNF1β were positive in 22.6%, 46.5%, and 61%, respectively, of the tumor immunoprofiles. Although several variables were associated with times to recurrence and cancer death in univariate Cox analyses, only AFP expression for time to recurrence, and the Milan criteria and HNF1β expression for times to recurrence and cancer death, remained significant after multivariate adjustment. Expression of HNF1β, but not of HNF1α, was related to serum AFP ≥200 ng/mL, microvascular invasion, and AFP expression (p<0.05). A subgroup analysis showed that in the within-Milan group, recurrence and cancer death rates at 10 years in the HNF1β-negative patients were approximately one-tenth of those in the HNF1β-positive patients, but the difference was not significant in the non-Milan group. Addition of HNF1β expression to the Milan criteria increased the c statistics and AU-ROCs for both recurrence and mortality (p<0.05). CONCLUSIONS: Immunohistological detection of HNF1β predicts recurrence and death specific for HCC post-transplant, and provides an additive benefit over the Milan selection criteria on their own. © 2012 American Association for the Study of Liver Diseases.
Authors:
Ju Hyun Shim; Han Chu Lee; Seungbong Han; Hyo Jeong Kang; Eunsil Yu; Sung-Gyu Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-2
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Association for the Study of Liver Diseases.
Affiliation:
Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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