Background: Up-regulation of Wnt-1 protein has been reported in hepatitis B virus (HBV) -related and hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) tissues and cell lines. It is known to play a fundamental role in signaling cancer progression, whereas its prognostic role in HCC remains unexplored. Methods: As a prognostic biomarker, this study analyzed Wnt-1 protein expression in 63 histology-verified HCC patients receiving curative resection. In each paired tumor and nontumor specimen, Wnt-1 levels were semiquantitatively measured by Western blotting and expressed by tumor/nontumor ratio. The data were further correlated with quantitative real-time PCR as well as with B-catenin and E-cadherin expression by immunohistochemistry. Cumulative tumor recurrencefree survival curves were constructed using the KaplanMeier method and compared by the log-rank test.
Results:The results showed that 26 (group I) and 37 (group II) HCC patients had an expression ratio of Wnt-1 z1.5 and <1.5, respectively. The amount of Wnt-1 estimated by tumor/nontumor ratio correlated with the results by quantitative real-time PCR. High tumor Wnt-1 expression correlated with enhanced nuclear B-catenin accumulation, diminished membranous E-cadherin expression, and increased tumor recurrence after curative tumor resection. Conclusions: These results suggest that Wnt-1 may be used as a predisposing risk factor for HCC recurrence. The use of tumor Wnt-1 as prognostic biomarker may identify patients with HBV-and/or HCV-related HCC patients with a high risk of tumor recurrence who may then benefit from further intensive therapy after surgery.
IntroductionWnt signaling, initially discovered by genetic analysis in the wing development of Drosophila melanogaster, is crucial in regulating many processes during embryonic development, including cell fate, organogenesis, angiogenesis, and stem cell proliferation (1, 2). In humans, 19 WNT genes encoding for 19 WNT proteins have been identified (3, 4). They are similar in size, ranging from 39 kDa (WNT7a) to 46 kDa (WNT10a), and share 27% to 83% amino acid sequence homology as well as a conserved pattern of 23 to 24 cysteine residues. WNT proteins have also been implicated in bone density maintenance, neurologic conditions during adulthood, and carcinogenesis of many cancers (5-8). The members of the WNT gene family are increasingly being discovered in other species, such as sea anemones (9). The first member of the 19 known human Wnt genes, wingless type mouse mammary tumor virus integration site gene family member 1 (Wnt-1), was discovered because of its oncogenic properties (10). The 19 known human Wnt ligands may interact with at least 10 cognate receptors of the Frizzled or planar cell polarity and/or low-density lipoprotein receptor-related protein 5/6 families to form receptor complexes. However, the signals transduced by different combinations of Wnt ligands and receptors are not yet completely understood (11).Chronic infections with hepatitis B and C viruses (HBV and HCV) ...