Hyeon Jiyeon, Ahn Soomin, Lee Jae Jun, Song Dae Hyun, Park Cheol-Keun
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Pathol. 2013 Apr;47(2):130-6. doi: 10.4132/KoreanJPathol.2013.47.2.130. Epub 2013 Apr 24.
BCL9 enhances β-catenin-mediated transcriptional activity regardless of the mutational status of the Wnt signaling components and increases the cell proliferation, migration, invasion, and metastatic potential of tumor cells. The goal of this study was to elucidate the prognostic significance of BCL9 protein expression in hepatocellular carcinoma (HCC) patients.
We evaluated BCL9 protein expression by immunohistochemistry in tumor tissue from 288 primary HCC patients who underwent curative hepatectomy. The impact of BCL9 expression on the survival of the patients was analyzed. The median follow-up period was 97.1 months.
Nuclear BCL9 protein expression was observed in 74 (25.7%) of the 288 HCCs. BCL9 expression was significantly associated with younger age (p=0.038), higher Edmondson grade (p=0.001), microvascular invasion (p=0.013), and intrahepatic metastasis (p=0.017). Based on univariate analyses, BCL9 expression showed an unfavorable influence on both disease-free survival (DFS, p=0.012) and disease-specific survival (DSS, p=0.032). Multivariate analyses revealed that higher Barcelona Clinic Liver Cancer stage was an independent predictor of both shorter DFS (p<0.001) and shorter DSS (p<0.001). BCL9 expression tended to be an independent predictor of shorter DFS (p=0.078).
BCL9 protein expression might be a marker of shorter DFS in HCC patients after curative hepatectomy.
BCL9可增强β-连环蛋白介导的转录活性，而与Wnt信号通路成分的突变状态无关，并增加肿瘤细胞的增殖、迁移、侵袭和转移潜能。本研究的目的是阐明BCL9蛋白表达在肝细胞癌（HCC）患者中的预后意义。
我们通过免疫组织化学评估了288例行根治性肝切除术的原发性HCC患者肿瘤组织中BCL9蛋白的表达情况。分析了BCL9表达对患者生存的影响。中位随访期为97.1个月。
在288例HCC中，有74例（25.7%）观察到核BCL9蛋白表达。BCL9表达与较年轻的年龄（p=0.038）、较高的Edmondson分级（p=0.001）、微血管侵犯（p=0.013）和肝内转移（p=0.017）显著相关。单因素分析显示，BCL9表达对无病生存期（DFS，p=0.012）和疾病特异性生存期（DSS，p=0.032）均有不利影响。多因素分析显示，较高的巴塞罗那临床肝癌分期是DFS较短（p<0.001）和DSS较短（p<0.001）的独立预测因素。BCL9表达倾向于成为DFS较短的独立预测因素（p=0.078）。
BCL9蛋白表达可能是HCC患者根治性肝切除术后DFS较短的一个标志物。
