Liver Research Center and Department of Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
PLoS One. 2011;6(10):e26323. doi: 10.1371/journal.pone.0026323. Epub 2011 Oct 17.
Hepatoma up-regulated protein (HURP) is a component of the chromatin-dependent pathway for spindle assembly. We examined the prognostic predictive value of HURP in human hepatocellular carcinoma (HCC).
HURP expression was evaluated by immunocytochemistry of fine needle aspirated hepatoma cells in 97 HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage A. Subsequently, these patients underwent partial hepatectomy (n = 18) or radiofrequency ablation (n = 79) and were followed for 2 to 35 months. The clinicopathological parameters were submitted for survival analysis.
HURP expression in aspirated HCC cells was detected in 19.6% patients. Kaplan-Meier survival analysis showed that positive HURP expression (P = 0.023), cytological grading ≥3 (P = 0.008), AFP ≥35 ng/mL (P = 0.039), bilirubin ≥1.3 mg/dL (P = 0.010), AST ≥50 U/L (P = 0.003) and ALT ≥35 U/L (P = 0.005) were all associated with a shorter disease-free survival. A stepwise multivariate Cox proportional hazard model revealed that positive HURP expression (HR, 2.334; 95% CI, 1.165-4.679, P = 0.017), AST ≥50 U/L (HR, 3.697; 95% CI, 1.868-7.319, p<0.001), cytological grade ≥3 (HR, 4.249; 95% CI, 2.061-8.759, P<0.001) and tumor number >1 (HR, 2.633; 95% CI, 1.212-5.722, P = 0.014) were independent predictors for disease-free survival. By combining the 4 independent predictors, patients with different risk scores (RS) showed distinguishable disease-free survival (RS≤1 vs. RS = 2, P = 0.001; RS = 2 vs. RS = 3, P<0.001). In contrast, the patients cannot be separated into prognosis distinguishable subgroups by using AJCC/UICC TNM staging system.
HCC patients with BCLC stage A can be separated into three prognosis-distinguishable groups by use of a risk score that is based upon HURP expression in aspirated HCC cells, ALT, cytological grade and tumor number.
肝癌上调蛋白（HURP）是纺锤体组装染色质依赖性途径的一个组成部分。我们研究了 HURP 在人肝细胞癌（HCC）中的预后预测价值。
通过免疫细胞化学法检测 97 例巴塞罗那临床肝癌（BCLC）分期 A 的 HCC 患者细针抽吸肝细胞中的 HURP 表达。随后，这些患者接受了部分肝切除术（n=18）或射频消融术（n=79），并随访 2 至 35 个月。对临床病理参数进行生存分析。
在 19.6%的患者中检测到 HURP 在抽吸 HCC 细胞中的表达。Kaplan-Meier 生存分析显示，HURP 阳性表达（P=0.023）、细胞学分级≥3（P=0.008）、AFP≥35ng/ml（P=0.039）、胆红素≥1.3mg/dL（P=0.010）、AST≥50U/L（P=0.003）和 ALT≥35U/L（P=0.005）均与无病生存率缩短相关。逐步多变量 Cox 比例风险模型显示，HURP 阳性表达（HR，2.334；95%CI，1.165-4.679，P=0.017）、AST≥50U/L（HR，3.697；95%CI，1.868-7.319，p<0.001）、细胞学分级≥3（HR，4.249；95%CI，2.061-8.759，P<0.001）和肿瘤数目>1（HR，2.633；95%CI，1.212-5.722，P=0.014）是无病生存率的独立预测因素。通过结合 4 个独立的预测因素，不同风险评分（RS）的患者显示出可区分的无病生存率（RS≤1 与 RS=2，P=0.001；RS=2 与 RS=3，P<0.001）。相比之下，使用 AJCC/UICC TNM 分期系统无法将患者分为预后可区分的亚组。
BCLC 分期为 A 的 HCC 患者可根据 HURP 在抽吸 HCC 细胞中的表达、ALT、细胞学分级和肿瘤数目，分为三组预后可区分的患者。
