Abstract
Recently, protocadherin 20 has been reported as a tumor suppressor gene in hepatocellular carcinoma (HCC); however, the prognostic value of protocadherin 20 in HCC remains unclear. Hence, the purpose of this study was to investigate the clinical and prognostic values of protocadherin 20 in HCC patients. The expression of protocadherin 20 was assessed by quantitative real-time polymerase chain reaction, western blot, and immunohistochemistry. Kaplan-Meier curves were created to calculate the overall survival of the patients, and Cox regression models were used to identify the risk factors associated with prognosis. Of 317 primary HCC patients, decreased expression of protocadherin 20 was observed in 184 (58.0%) patients (P < 0.001). Reduced protocadherin 20 protein expression correlated with portal hypertension, poor tumor differentiation, advanced Okuda stage, and Cancer of the Liver Italian Program score (all P < 0.05). Low protocadherin 20 expression was an independent risk factor for mortality (P = 0.018). Furthermore, in our newly developed simple risk score based on protocadherin 20, patients with total score > 1.11 showed significantly poorer outcome; and the predictive value of the score was better than the Barcelona Clinic Liver Cancer stage, Okuda stage, and Child-Pugh classification (Harrell's concordance index = 0.614). Taken together, these findings suggest that protocadherin 20 may represent a novel prognostic biomarker for HCC patients.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide
These findings suggest that protocadherin 20 may represent a novel prognostic biomarker for hepatocellular carcinoma (HCC) patients
The expression levels of protocadherin 20 (PCDH20) were tested by quantitative real-time polymerase chain reaction and western blot in 50 patients; and we found that the mean level of PCDH20 expression in the tumor tissues was significantly lower than that in the PC tissues (Figure 1)
Summary
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. Most HCC patients are diagnosed at the advanced stages of tumor progression. The protocadherin (PCDH) family, a subfamily of the cadherin family, can be divided into two groups based on the genomic structure: clustered and non-clustered [3]. PCDH20 ( known as PCDH13) is a novel protocadherin located at 13q21.2. It comprises six extracellular domains, a single transmembrane region, and distinct cytoplasmic portions [21]. The latest studies showed reduced expressions of PCDH20 in non-small cell lung cancer [18], nasopharyngeal carcinoma [19], and HCC [20]
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