Prognostic significance of DNA topoisomerase IIalpha expression in human hepatocellular carcinoma.

BACKGROUND

The biological significance of the nuclear enzyme DNA topoisomerase II in hepatocellular carcinoma (HCC) remains unclear.

MATERIALS AND METHODS

Using immunohistochemical staining methods, we examined the clinical significance of topo IIalpha (8D2) in surgically resected HCC, comparing the expression of both Ki-67 and p53, as well as various clinicopathological factors and prognosis.

RESULTS

The 70 HCC samples showed a positive, but heterogeneous pattern. The mean topo IIalpha labeling index (LI) was 14.1 +/- 15.1%, and ranged from 0.2 to 55.6, and the median topo IIalpha LI was 9.9%. The mean value of the topo IIalpha LI in p53-positive HCC cases (25.6 +/- 17.4) was significantly higher than that in p53-negative cases (10.3 +/- 12.3). HCC patients with lower topo IIalpha LI had significantly longer disease-free survival and exhibited a longer cumulative survival period than did those with higher topo lIalpha LI.

CONCLUSION

Topo IIalpha over-expression appears to be linked with a potentially aggressive tumor phenotype and may indicate tumor recurrence and cancer-related death in HCC.