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. 2019 Jun;98(26):e16084.
doi: 10.1097/MD.0000000000016084.

Can heme oxygenase-1 be a prognostic factor in patients with hepatocellular carcinoma?

Cheon-Soo Park  1 , Dae-Woon Eom  2 , Yongchel Ahn  3 , Hyuk Jai Jang  4 , Shin Hwang  5 , Sung-Gyu Lee  5
Affiliations

Can heme oxygenase-1 be a prognostic factor in patients with hepatocellular carcinoma?

Cheon-Soo Park et al. Medicine (Baltimore). 2019 Jun.

Abstract

Heme oxygenase-1 (HO-1) is an important catalytic enzyme in heme degradation, which increases during stressful conditions. It plays a major role in antioxidative and antiapoptotic processes and is associated with tumor growth and metastasis.This study aimed to evaluate the degree of HO-1 expressions in hepatocellular carcinoma (HCC) surgical specimens and the correlation between HO-1 expression and patient prognosis. Formalin-fixed, paraffin-embedded HCC tissue samples (n = 96) were included in the analysis, and the expression of HO-1 was evaluated by immunohistochemical staining. We reviewed clinical features of patients and evaluated the prognostic role of HO-1 in patient survival and recurrence.Positive HO-1 expression was identified in 43 cases (44.8%) and was frequently found in patients with advanced histology (Edmondson-Steiner [E-S] grade 2, 3, 4), α-fetoprotein (AFP) level of more than 200 IU/mL, and the presence of microvascular and capsular invasion (P < .05). In the univariate analysis, the overall survival (OS) and disease-free survival (DFS) of patients with HO-1-positive HCC were not statistically different from those with HO-1-negative HCC. Moreover, HO-1 expression was not associated with patient survival and recurrence based on the multivariate analysis. In the subgroup analysis of patients without preoperative transarterial chemoembolization (TACE) (n = 61), HO-1 was not also associated with tumor recurrence (P = .681).The clinical implication of HO-1 activity is controversial in various malignancies. However, HO-1 expression did not seem to influence the prognosis of HCC patients.

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Conflict of interest statement

There is no potential conflict of interest relevant to this article.

Figures

Figure 1
Figure 1
Schematic illustration of the heme oxygenase pathway. CO = carbon monoxide, Fe2+ = ferrous ion, UV = ultraviolet.
Figure 2
Figure 2
The hepatocellular carcinoma cells (A, H&E 200×) were diffusely positive for heme oxygenase-1 (B, IHC 200×). On the other hand, hepatocellular carcinoma cells (C, H&E 200×) were negative for heme oxygenase-1 expression (D, IHC 200×).
Figure 3
Figure 3
Kaplan–Meier analysis of hepatocellular carcinoma recurrence (n = 96). HO-1 = heme oxygenase-1.
Figure 4
Figure 4
Kaplan-Meier analysis of hepatocellular carcinoma recurrence in the non-TACE group (n = 61). HO-1 = heme oxygenase-1, TACE = transarterial chemoembolization.
See this image and copyright information in PMC

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