Purpose: Limb-bud and heart (LBH) levels are correlated with adverse survival in several malignancies; however, their significance in hepatocellular carcinoma (HCC) remains unclear. The objective of this study was to determine the association between LBH status and clinical outcomes.
Methods: We selected 226 patients with HCC who were treated surgically between 2003 and 2010 at a single academic center. Immunohistochemistry (IHC) was used to detect the protein expression of LBH in HCC samples. Receiver operating characteristic (ROC) curve analysis, Spearman's rank correlation, Kaplan-Meier plots, and the Cox proportional hazards regression model were used to analyze the data.
Results: A high expression of LBH was detected in 20 (8.8%) of 226 HCC samples. Correlation analysis demonstrated that LBH in HCC was significantly correlated with aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels and clinical stages (P<0.05). In the Kaplan-Meier analysis, the mean survival time of patients with low levels of LBH was longer than that for those with high levels of LBH (P<0.05). The 3-year overall survival rate was 20% for patients with HCC and high levels of LBH versus 67% for patients with HCC and low levels of LBH. In the multivariate analysis, AST/ALT level, clinical stage, tumor relapse, and the level of LBH were the independent prognostic factors for overall survival (P<0.05).
Conclusion: Overexpression of LBH might contribute to the development and progression of HCC. LBH could be a novel prognostic marker for HCC.
Keywords: LBH; hepatocellular carcinoma; immunohistochemistry; prognosis.