Significance of p53, cyclooxygenase-2, and epithelial cell adhesion molecule expression in hepatocellular carcinoma: an immunohistochemical study

Abstract

Background Hepatocellular carcinoma (HCC) is a significant global health concern with a high mortality rate. To date, the most effective therapy for HCC is resection at an early tumor stage. However, tumor recurrence is common, and identifying key molecules facilitates the understanding of the pathogenesis of HCC and the prediction of prognosis to provide novel targets for anticancer therapy. Aim This study evaluated the expression of p53, cyclooxygenase-2 (COX-2), and epithelial cell adhesion molecule (EpCAM) in HCC and investigated their correlation with clinicopathological features and prognosis. Methods An Immunohistochemical analysis of p53, COX-2, and EpCAM was conducted on selected 51 HCC cases and adjacent noncancerous hepatic tissue. Results In the current study, p53, COX-2, and EpCAM expression were significantly higher in HCC cases than in the adjacent nontumor tissue (P=0.05, P=0.03, and P=0.041, respectively). P53, COX-2, and EpCAM were significantly overexpressed among patients with advanced stage (P=0.039, P=0.000, and P=0.016, respectively), large tumor size (P=0.004 and P=0.001) and poor disease-free survival (P=0.036, P=0.001, and P=0.000, respectively). P53 and EpCAM were significantly correlated with vascular invasion (P=0.045 and P=0.032) and higher grade (P=0.019 and P=0.033). While COX-2 was associated with well-differentiated HCC cases. There was no statistically significant correlation between p53 and COX-2 or, EpCAM, while COX-2 was directly correlated with EpCAM (r=0.001). Conclusion p53, COX-2, and EpCAM might have an important role in early carcinogenesis, progression of HCC, and poor prognosis, suggesting that the inhibition of these proteins may hold potential as a multitarget therapeutic approach in HCC patients.