Abstract
Hepatocellular carcinoma (HCC) is the second common cause of cancer-related death in Taiwan. Tumor recurrence is frequently observed in HCC patients receiving surgical resection, resulting in unsatisfactory overall survival (OS). Therefore, it is pivotal to identify effective prognostic makers, so that intensive surveillance or adjuvant treatments can be applied to predictively unfavorable patients. Previous studies indicated that Annexin A2 (ANXA2) was an effective prognostic marker in several cancers, including HCC. However, the prognostic value of ANXA2 in Taiwanese HCC patients remains unclear, where a great proportion of patients had chronic hepatitis B with liver cirrhosis. Here, ANXA2 was highly expressed in HCC tissues compared with para-neoplastic noncancerous tissues. Furthermore, high ANXA2 expression in HCC tissues independently predicted shorter OS. In subgroup analysis, however, ANXA2 expression could not effectively predict OS in the following subgroups: female, age > 65 years old, Child–Pugh classification B, hepatitis B virus surface antigen negative or anti-hepatitis C antibody positive, alcoholism, tumor number >1, presence of micro- or macrovascular invasion, absence of capsule, non-cirrhosis and high alpha-fetoprotein. In conclusion, ANXA2 expression in HCC tissues could predict postoperative OS. However, the predictive value was limited in patients with specific clinical conditions.
Highlights
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in Taiwan [1]
We found that Annexin A2 (ANXA2) expression was highly expressed in HCC tissues compared to noncancerous tissues (Figure 1A, p < 0.001)
We found that high expression of ANXA2 in HCC tissues was associated with a significantly shorter overall survival (OS), indicating that ANXA2 was a predictor for unfavorable prognosis in liver cancer
Summary
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in Taiwan [1]. Can lead to chronic hepatitis, liver fibrosis, cirrhosis and eventually HCC [2]. Despite the improvement in the treatment of chronic viral hepatitis and the successful implantation of neonatal vaccination program against HBV, HCC is still a severe public health concern in Taiwan [3]. Surgical treatment is considered one of the most efficient therapies for earlystage HCC. Incidence of tumor recurrence and distant metastasis remains high in HCC patients receiving surgical resection, resulting in unsatisfactory clinical outcomes. Several biomarkers such as alpha-fetoprotein (AFP) were used for diagnosis and outcome prediction in HCC patients. It is very important to identify new prognostic makers for these patients, so that more intensive surveillance and/or adjuvant treatments, if available, could be applied to unfavorable patients
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