Evaluation of the relationship between immunohistochemical markers and the prognosis of patients with hepatocellular carcinoma

Abstract

Aims: This study aimed to evaluate whether prognosis and survival time in patients hepatocellular carcinoma (HCC) were associated with immunohistochemistry results for Heat Shock Protein 70 (HSP70), Glutamine synthetase (GS), Cyclase Associated Protein 2 (CAP2), Enhancer of zeste homolog 2 (EZH2) and B-cell-specific Moloney murine leukemia virus integration site 1 (Bmi-1). Methods: In this retrospective study, the medical records of 50 HCC cases were evaluated. Tissues were stained for the targeted antigens. Immunohistochemical stains were scored for cytoplasmic (HSP70, GS, CAP2) or nuclear (EZH2, Bmi-1) staining patterns under light microscopy. Results: Twenty-nine (58%) of the HCC cases died and the overall survival time was 30±3 (24-37) months. Survival times were similar in terms of age (p=0.262), sex (p=0.707), cause of disease (p=0.655), tumor size (p=0.191) and degree of differentiation (p=0.280). The overall survival of HCC patients with vascular invasion was shorter (p=0.019). The frequency of EZH2 (p=0.025) and Bmi-1 (p=0.004) +/++ was higher in patients with vascular invasion. No correlation was found between overall survival time and HSP70 positivity (p=0.140) and CAP2 positivity (p=0.278); however, survival time was significantly shorter in HCC cases stained (++/+++) with EZH2 (p=0.034), Bmi-1 (p=0.008) and GS (p=0.018). Conclusion: The results of this study showed that GS, EZH2, and Bmi-1 predicted prognosis and survival time in patients with HCC, possible due to relationships with vascular invasion. There is a need for more comprehensive, population-based studies on biomarkers that can be used in prognosis monitoring of HCC cases.