Abstract
Background The functions of Wnt-5a in human cancers are controversial and unclear. Aim To investigate the clinical significance of Wnt-5a expression in hepatocellular carcinoma. Patients and methods Real-time quantitative Reverse transcriptase Polymerase Chain Reaction was done to evaluate Wnt-5a gene expression. Wnt-5a, β-catenin, E-cadherin and Ki-67 were examined immunohistochemically in 114 hepatocellular carcinoma cases. Results Compared to normal tissue, Wnt-5a mRNA expression was clearly increased in hepatocellular carcinoma, chronic hepatitis and cirrhosis. On immunohistochemistry, immunostaining of Wnt-5a showed a bell-shaped pattern: low to undetectable levels were present in normal tissue and in tumour samples, whereas strong immunostaining was seen in chronic hepatitis, cirrhosis and dysplastic liver cells. Reduction or loss of Wnt-5a protein expression was found in 80.7% of hepatocellular carcinoma cases ( n = 92) and was significantly associated with higher tumour stage ( p < 0.001), serum AFP level ( p = 0.025), low membranous expression of E-cadherin ( p < 0.0001) and β-catenin ( p = 0.036) and high Ki-67 labelling indices (LIs, p = 0.001). Conclusion Wnt-5a mRNA and protein levels are higher than normal in hepatitis and cirrhosis and appear to be related to the presence of hepatitis B virus infection. However, Wnt-5a protein expression is frequently lost in hepatocellular carcinoma; this supports the notion that this protein has a tumour suppressor function in hepatocellular carcinoma.
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