Prognostic Effect Of EpCAM In Hepatocellular Carcinoma And Its Association With Ductular Reactions

Part ⅠClinicopathological study of EpCAM expression in hepatocellular carcinomaObjective:To evaluate the expression of EpCAM in hepatocellular carcinoma (HCC), and its association with clinicopathologic features.Methods:The clinicopathological characteristics and EpCAM expression were analyzed in106patients who received curative hepatectomy for HCC at the Eastern Hepatobiliary Surgery Hospital between February2001and July2003. Follow-up was completed in December2009. Immunohistochemical analysis of EpCAM was performed on tumor tissue sections. Association between EpCAM expression and clinicopathologic features were performed by statistical analysis.Results:Significantly poor prognosis was recognized in HCC with high EpCAM expression in overall survival (p<0.001) and recurrence-free survival (p<0.002). High expression of EpCAM in HCC was associated with poorer tumor encapsulation (p <0.001), larger tumor size (>5cm, p=0.019), higher level of serum AFP (p=0.004), advanced TNM stage (p=0.011),poor overall survival and recurrence free survival (p=0.0005,p=0.0019).Conclusions:Expression of EpCAM might play a critical role in the aggressiveness of HCC. Part ⅡSurvival analysis of hepatocellular carcinoma after hepatectomyObjective:To evaluate the risk factors associated with poor overall and recurrence free survival in hepatocellular carcinoma after curative hepatectomy.Methods:The clinicopathological characteristics and EpCAM expression were analyzed in106patients who received curative hepatectomy for HCC at the Eastern Hepatobiliary Surgery Hospital between February2001and July2003. Overall survival rates and recurrence free survival rates were estimated by the Kaplan-Meier method. Survival curves were compared using the Log-Rank test. Variables with p<0.1in univariate analysis were subjected to multivariate Cox regression modeling using forward stepwise variable selection.Results:BCLC stage (HR=3.091,95%CI=1.824-5.236,p<0.001), tumor size (HR=2.031,95%CI=1.191-3.463,p=0.009) and EpCAM expression (HR=1.904,95%CI=1.214-2.987, p=0.005) were independent factors associated with overall survival. TNM stage (HR=3.728,95CI=2.207-6.297, p<0.001), EpCAM expression (HR=1.708,95%CI=1.089-2.679,p=0.020) were independent factors associated with recurrence free survival. Multivariate analysis revealed that the status of EpCAM expression was an independent factor affecting overall survival and recurrence free survival of HCC.Conclusions:Expression of EpCAM is an independent factor affecting overall survival and recurrence free survival of HCC. Part ⅢCorrelation between EpCAM expression and Ductular ReactionsObjective:To evaluate the expression of Ductular Reactions in the non-tumor liver tissue and its association with EpCAM expression in HCC.Methods:Tumor and corresponding non-tumor liver tissues were obtained from106consecutive patients who received curative hepatectomy for HCC at the Eastern Hepatobiliary Surgery Hospital between February2001and July2003. Immunohistochemical analysis of EpCAM and Ductular Reactions was performed on tumor tissue and non-tumor liver sections. Association between EpCAM expression and ductular reactions were performed by statistical analysis.Results:Significantly correlation was found between EpCAM expression and Ductular Reactions. Elevated EpCAM expression was closely associated with the status of ductular reactions in HCC patients (p=0.016).Conclusions:Elevated Ductular Reactions might play an important role in the expression of EpCAM in HCC.