Taha Noura Ali, Shafiq Ahmed Mahran, Mohammed Abdallah Hedia, Zaky Amen Hamdy, Omran Ola M, Ameen Mahmoud Gamal
Department of Medical Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
World J Oncol. 2023 Aug;14(4):285-299. doi: 10.14740/wjon1608. Epub 2023 Jul 12.
Early diagnosis and proper management of hepatocellular carcinoma (HCC) improve patient prognosis. Several studies attempted to discover new genes to understand the pathogenesis and identify the prognostic and predictive factors in HCC patients, to improve patient's overall survival (OS) and maintain their physical and social activity. The transcription factor FOS-like antigen 1 (FOSL1) acts as one of the important prognostic factors in different tumors, and its overexpression correlates with tumors' progression and worse patient survival. However, its expression and molecular mechanisms underlying its dysregulation in human HCC remain poorly understood. Our study was conducted to evaluate the expression of FOSL1 in HCC tissues and its relationship with various clinicopathological parameters besides OS.
This study is a retrospective cohort study conducted among 113 patients with a proven diagnosis of HCC, who underwent tumor resection and received treatment at South Egypt Cancer Institute. Immunohistochemistry for FOSL1 expression and survival curves were conducted followed by statistical analysis.
HCC occurred at older age group and affected males more than females. There was a statistically significant correlation between combined cytoplasmic and nuclear expression of FOSL1 and worse prognosis in HCC patients. There was a statistically significant correlation of FOSL1 expression with histological grade, lymphovascular embolization, and tumor budding where high expression indicated potential deterioration of HCC patients. There was statistically significant correlation between tumor size, tumor grade and FOSL1 expression with the cumulative OS.
Combined cytoplasmic and nuclear FOSL1 expression has significant prognostic association with HCC and diagnostic importance, as it can identify cirrhosis and premalignant lesions that can progress to HCC. Furthermore, Kaplan-Meier survival analysis found that overexpressed FOSL1 was correlated with poor OS.
肝细胞癌（HCC）的早期诊断和恰当管理可改善患者预后。多项研究试图发现新基因，以了解其发病机制，并确定HCC患者的预后和预测因素，从而提高患者的总生存期（OS），并维持其身体和社交活动能力。转录因子FOS样抗原1（FOSL1）是不同肿瘤中重要的预后因素之一，其过表达与肿瘤进展及患者较差的生存率相关。然而，其在人类HCC中的表达及其失调的分子机制仍知之甚少。我们开展本研究旨在评估FOSL1在HCC组织中的表达及其与除OS之外的各种临床病理参数的关系。
本研究是一项回顾性队列研究，对象为113例经证实诊断为HCC的患者，这些患者在埃及南部癌症研究所接受了肿瘤切除和治疗。进行了FOSL1表达的免疫组织化学检测和生存曲线分析，随后进行统计分析。
HCC多发生于老年人群，男性受累多于女性。FOSL1在细胞质和细胞核中的联合表达与HCC患者较差的预后之间存在统计学显著相关性。FOSL1表达与组织学分级、淋巴管栓塞和肿瘤芽生之间存在统计学显著相关性，高表达提示HCC患者病情可能恶化。肿瘤大小、肿瘤分级和FOSL1表达与累积OS之间存在统计学显著相关性。
FOSL1在细胞质和细胞核中的联合表达与HCC具有显著的预后相关性和诊断重要性，因为它可以识别可能进展为HCC的肝硬化和癌前病变。此外，Kaplan-Meier生存分析发现，FOSL1过表达与较差的OS相关。
