The prognostic significance of clinical and pathological features in hepatocellular carcinoma

Abstract

The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, s u c h a s p a t i e n t ' s g e n e r a l c o n d i t i o n s , macroscopic tumor morphology, as well as tumor hitopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are w o r s e t h a n t h e o l d e r o n e s . C o -e x i s t i n g hepatitis status and hepatic functional reserve h a v e b e e n c o n f i r m e d a s r i s k f a c t o r s f o r recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and a d v a n c e d p T N M s t a g e , a r e t h e b e s testablished risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. E x t r a t u m o r s p r e a d i n g a n d l y m p h n o d a l metastasis are independent predictors for poor outcome. Some new predictive systems h a v e r e c e n t l y b e e n p r o p o s e d . D i f f e r e n t strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only p o t e n t i a l l y c u r a t i v e t r e a t m e n t f o r H C C , including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserves further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.Qin LX,Tang ZY.The prognostic significance of clinical and pathological features in hepatocellular carcinoma.

Prognostic analysis of pulmonary metastases from hepatocellular carcinoma

“…AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence [7]. The c-GT is one of the liver functional and HCC markers.…”

“…The c-GT is one of the liver functional and HCC markers. It is an important predictive marker for disease-free survival (DFS) of HCC patients [7]. Higher c-GT level shows a significant effect on lower survival [2].…”

Overexpression of NDRG1 is an indicator of poor prognosis in hepatocellular carcinoma

“…Clinically, high tumor differentiation grade and the presence of vascular invasion are significant independent predictors of patient survival. 22,23 An earlier study by our group generated gene expression profiles of hepatocellular carcinoma in order to increase our understanding of the molecular pathophysiology of hepatocellular carcinoma, as well as to identify genetic fingerprints with diagnostic or prognostic significance. 7 We reanalyzed these gene expression profiles using GABRIEL in order to extract biologically and clinically meaningful results, and identified NDRG1 as one of the most significantly upregulated genes in hepatocellular carcinoma when compared to nontumor liver.…”

Overexpression of CYP2E1 enhances sensitivity of HepG2 cells to Fas-mediated cytotoxicity

“…1 Although several effective therapies have been established for the early stages of this disease, HCC at advanced stages is still resistant to treatment, and its prognosis remains very poor. 2 Thus, the need to identify effective hepatoma therapies is obvious.…”