Schöniger-Hekele M et al. (2005) Hepatocellular carcinoma—survival and clinical characteristics in relation to various histologic molecular markers in Western patients. Liver Int 25: 62–69

Survival is highly variable in patients with hepatocellular carcinoma and new prognostic markers are needed. A recent study by Schöniger-Hekele and colleagues in Austria has investigated the potential role of several molecular histologic markers involved in proliferation, cell cycle, metastatic potential and immunogenicity.

The expression of Ki-67, HER2/neu, p53, mdm2, p21, CD81, and HLA-DR was investigated in tumor tissue samples from 81 patients with hepatocellular carcinoma. These results were correlated with patient survival using the Kaplan–Meier method. In addition, associations were sought between expression of the various markers and clinical characteristics, including tumor size and grade, portal-vein invasion and lymph-node metastasis.

Associations were shown between two cell-cycle markers and survival. Tumors showing nuclear accumulation of p53 were associated with worse survival than those that did not accumulate p53 (median survival 4.1 months vs 9.3 months, P = 0.018). An inverse relationship was found between tumor expression of mdm2 and survival; patients with low levels of mdm2 expression survived for a median period of 9.4 months, compared with only 3.9 months for those with high expression. In addition, patients with enlarged lymph nodes were more likely to have HLA-DR-positive tumors, and tumors expressing CD81 were less frequent in patients with distant metastases.

In summary, the study revealed several markers that might be useful, in combination with information on patient and tumor characteristics, in the development of new prognostic models for hepatocellular carcinoma.