Department of Endocrinology, Punan Hospital, Shanghai 200125, China.
J Cancer Res Clin Oncol. 2011 Apr;137(4):651-8. doi: 10.1007/s00432-010-0927-3. Epub 2010 Jun 15.
Metabolic syndrome and insulin resistance have been linked to increased risk of occurrence and mortality of hepatocellular carcinoma (HCC). Recently, retinol-binding protein 4 (RBP4) was clarified as a specific serological marker of insulin resistance. The aim of this study was to determine whether serum RBP4 could be used as a potential marker for predicting prognosis in patients with HCC after curative resection.
Western immunoblotting and Enzyme-linked immunosorbent assay were used to measure the RBP4 expression in cell lines, supernatant, and serum. Serum RBP4 levels were compared with clinicopathological features and outcomes of patients with HCC. Furthermore, we investigated the impact of serum RBP4 level, serum C-peptide level, and HOMA-IR on overall survival (OS) and disease-free survival (DFS) of patients with HCC in the training cohort (156 patients with HCC), and then were validated in the validation cohort (105 patients with HCC).
RBP4 protein overexpressed in HCC cell lines compared with normal liver cell line (P < 0.001) and correlated with metastatic potential. Serum RBP4 levels were associated with OS [hazard ratio (HR) = 2.208, P < 0.001] and DFS (HR = 1.878, P = 0.029) of patients with HCC. By multivariate analysis, the serum RBP4 level was identified as an independent factor for OS (HR = 2.170, P = 0.004) and DFS (HR = 1.769, P = 0.037) of patients with HCC. The prognostic value of serum RBP4 level was confirmed in the validation cohort.
The serum RBP4 level is potential to be a useful prognostic factor for HCC after curative resection.
代谢综合征和胰岛素抵抗与肝细胞癌（HCC）的发生和死亡率增加有关。最近，视黄醇结合蛋白 4（RBP4）被明确为胰岛素抵抗的特异性血清标志物。本研究旨在确定血清 RBP4 是否可作为预测 HCC 患者根治性切除后预后的潜在标志物。
采用 Western 免疫印迹和酶联免疫吸附试验检测细胞系、上清液和血清中的 RBP4 表达。比较血清 RBP4 水平与 HCC 患者的临床病理特征和结局。此外，我们在训练队列（156 例 HCC 患者）中研究了血清 RBP4 水平、血清 C 肽水平和 HOMA-IR 对 HCC 患者总生存期（OS）和无病生存期（DFS）的影响，并在验证队列（105 例 HCC 患者）中进行了验证。
RBP4 蛋白在 HCC 细胞系中过度表达，与正常肝细胞系相比（P<0.001），且与转移潜能相关。血清 RBP4 水平与 HCC 患者的 OS [风险比（HR）=2.208，P<0.001]和 DFS（HR=1.878，P=0.029）相关。多因素分析显示，血清 RBP4 水平是 HCC 患者 OS（HR=2.170，P=0.004）和 DFS（HR=1.769，P=0.037）的独立因素。血清 RBP4 水平的预后价值在验证队列中得到了证实。
血清 RBP4 水平可能是 HCC 根治性切除后有用的预后因素。
