Background Developing predictive markers for hepatocellular carcinoma (HCC) is important, because many patients experience recurrence and metastasis. Epithelial to mesenchymal transition (EMT) is a developmental process that plays an important role during embryogenesis and also during cancer metastasis. Paired-related homeobox protein 1 (Prrx-1) is an EMT inducer that has recently been introduced, and its prognostic significance in HCC is largely unknown.
Methods Tissue microarray was constructed using surgically resected primary HCCs from 244 cases. Immunohistochemical staining of E-cadherin and Prrx-1 was performed. The correlation between E-cadherin loss and Prrx-1 expression, as well as other clinicopathologic factors, was evaluated.
Results E-cadherin expression was decreased in 96 cases (39.4%). Loss of E-cadherin correlated with a higher recurrence rate (p < .001) but was not correlated with patient’s survival. Thirty-two cases (13.3%) showed at least focal nuclear Prrx-1 immunoreactivity while all non-neoplastic livers (n = 22) were negative. Prrx-1 expression was not associated with E-cadherin loss, survival or recurrence rates, pathologic factors, or the Ki-67 labeling index. Twenty tumors that were positive for E-cadherin and Prrx-1 had significantly higher nuclear grades than the rest of the cohort (p = .037). In Cox proportional hazard models, E-cadherin loss and large vessel invasion were independent prognostic factors for shorter disease-free survival. Cirrhosis and high Ki-67 index (> 40%) were independent prognostic factors for shorter overall survival.
Conclusions Prrx-1 was expressed in small portions of HCCs but not in normal livers. Additional studies with a large number of Prrx-1-positive cases are required to confirm the results of this study.
Citations
Citations to this article as recorded by
The Prognostic Importance of Ki-67 in Gastrointestinal Carcinomas: A Meta-analysis and Multi-omics Approach Mahdieh Razmi, Fatemeh Tajik, Farideh Hashemi, Ayna Yazdanpanah, Fatemeh Hashemi-Niasari, Adeleh Divsalar Journal of Gastrointestinal Cancer.2024; 55(2): 599. CrossRef
Homotypic cell-in-cell structures as an adverse prognostic predictor of hepatocellular carcinoma Ruizhi Wang, Yichao Zhu, Hao Zhong, Xinyue Gao, Qiang Sun, Meifang He Frontiers in Oncology.2022;[Epub] CrossRef
Dysregulated paired related homeobox 1 impacts on hepatocellular carcinoma phenotypes Weronika Piorońska, Zeribe Chike Nwosu, Mei Han, Michael Büttner, Matthias Philip Ebert, Steven Dooley, Christoph Meyer BMC Cancer.2021;[Epub] CrossRef
Analysis of genetic profiling, pathomics signature, and prognostic features of primary lymphoepithelioma‐like carcinoma of the renal pelvis Bo Fan, Yuanbin Huang, Hongshuo Zhang, Tingyu Chen, Shenghua Tao, Xiaogang Wang, Shuang Wen, Honglong Wang, Zhe Lin, Tianqing Liu, Hongxian Zhang, Tao He, Xiancheng Li Molecular Oncology.2022; 16(20): 3666. CrossRef
Lymphoepithelioma-like carcinoma of the upper urinary tract: A systematic review of case reports Shi-Cong Lai, Samuel Seery, Wei Zhang, Ming Liu, Guan Zhang, Jian-Ye Wang World Journal of Clinical Cases.2020; 8(4): 771. CrossRef
Rare primary lymphoepithelioma-like carcinoma of the renal pelvis Shi-Cong Lai, Samuel Seery, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu World Journal of Clinical Cases.2020; 8(9): 1752. CrossRef
Eight-year follow-up of locally advanced lymphoepithelioma-like carcinoma at upper urinary tract: A case report Che H Yang, Wei C Weng, Yi S Lin, Li H Huang, Chin H Lu, Chao Y Hsu, Yen C Ou, Min C Tung World Journal of Clinical Cases.2020; 8(19): 4505. CrossRef
Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder: a case report and systematic review for optimal treatment modality for disease-free survival Andy W. Yang, Aydin Pooli, Subodh M. Lele, Ina W. Kim, Judson D. Davies, Chad A. LaGrange BMC Urology.2017;[Epub] CrossRef