Expression of PEG10 Is Associated with Poor Survival and Tumor Recurrence in Hepatocellular Carcinoma
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Purpose Paternally expressed gene 10 (PEG10), first identified as an imprinted gene, is paternallyexpressed and maternally silenced. In hepatocellular carcinoma (HCC), PEG10 has beenidentified as a potential target gene located within the amplified 7q21 locus. The purposeof this study was to investigate the expression of PEG10 protein in HCC and evaluate itsprognostic significance. Materials and MethodsPEG10 protein expression was examined by immunohistochemistry in tumor tissues from218 HCC patients undergoing curative resection. Furthermore, the relationships betweenPEG10 expression and clinicopathologic features or postoperative survival of HCC patientswere evaluated. The median follow-up period was 119.8 months for survivors. ResultsPEG10 expression was observed in 148 of the 218 HCCs (67.9%) and was significantlycorrelated with younger age, female, higher Edmondson grade, microvascular invasion,intrahepatic metastasis, higher American Joint Committee on Cancer T-stage, and higher!-fetoprotein level. PEG10 expression was an independent predictor of early recurrence(p=0.013), and it showed an unfavorable influence on recurrence-free survival (p < 0.001). A subgroup analysis showed that among patients with !-fetoprotein " 20 ng/mL (80patients), the PEG10-positive group also showed an unfavorable influence on recurrencefreesurvival (p=0.002). Moreover, a multivariate survival analysis identified PEG10 as anindependent predictor of shorter recurrence-free survival (p=0.005). PEG10 expressionshowed an unfavorable influence on overall survival (p=0.007) but was not an independentpredictor of shorter overall survival (p=0.128). ConclusionPEG10 protein could be a potential biomarker predicting early recurrence and recurrencefreesurvival in HCC patients after curative resection, even in those with normal serum!-fetoprotein levels.
Abstract
Purpose Paternally expressed gene 10 (PEG10), first identified as an imprinted gene, is paternallyexpressed and maternally silenced. In hepatocellular carcinoma (HCC), PEG10 has beenidentified as a potential target gene located within the amplified 7q21 locus. The purposeof this study was to investigate the expression of PEG10 protein in HCC and evaluate itsprognostic significance. Materials and MethodsPEG10 protein expression was examined by immunohistochemistry in tumor tissues from218 HCC patients undergoing curative resection. Furthermore, the relationships betweenPEG10 expression and clinicopathologic features or postoperative survival of HCC patientswere evaluated. The median follow-up period was 119.8 months for survivors. ResultsPEG10 expression was observed in 148 of the 218 HCCs (67.9%) and was significantlycorrelated with younger age, female, higher Edmondson grade, microvascular invasion,intrahepatic metastasis, higher American Joint Committee on Cancer T-stage, and higher!-fetoprotein level. PEG10 expression was an independent predictor of early recurrence(p=0.013), and it showed an unfavorable influence on recurrence-free survival (p < 0.001). A subgroup analysis showed that among patients with !-fetoprotein " 20 ng/mL (80patients), the PEG10-positive group also showed an unfavorable influence on recurrencefreesurvival (p=0.002). Moreover, a multivariate survival analysis identified PEG10 as anindependent predictor of shorter recurrence-free survival (p=0.005). PEG10 expressionshowed an unfavorable influence on overall survival (p=0.007) but was not an independentpredictor of shorter overall survival (p=0.128). ConclusionPEG10 protein could be a potential biomarker predicting early recurrence and recurrencefreesurvival in HCC patients after curative resection, even in those with normal serum!-fetoprotein levels.
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