Wnt-1 protein as a prognostic biomarker for hepatitis B-related and hepatitis C-related hepatocellular carcinoma after surgery.

Background: Up-regulation of Wnt-1 protein has been reported in hepatitis B virus (HBV) – related and hepatitis C virus (HCV) – related hepatocellular carcinoma (HCC) tissues and cell lines. It is known to play a fundamental role in signaling cancer progression, whereas its prognostic role in HCC remains unexplored. Methods: As a prognostic biomarker, this study analyzed Wnt-1 protein expression in 63 histology-verified HCC patients receiving curative resection. In each paired tumor and nontumor specimen, Wnt-1 levels were semiquantitatively measured by Western blotting and expressed by tumor/nontumor ratio. The data were further correlated with quantitative real-time PCR as well as with B-catenin and E-cadherin expression by immunohistochemistry. Cumulative tumor recurrencefree survival curves were constructed using the KaplanMeier method and compared by the log-rank test. Results: The results showed that 26 (group I) and 37 (group II) HCC patients had an expression ratio of Wnt1 z1.5and <1.5 , respectively. The amount of Wnt-1 estimated by tumor/nontumor ratio correlated with the results by quantitative real-time PCR. High tumor Wnt-1 expression correlated with enhanced nuclear B-catenin accumulation, diminished membranous E-cadherin expression, and increased tumor recurrence after curative tumor resection. Conclusions: These results suggest that Wnt-1 may be used as a predisposing risk factor for HCC recurrence. The use of tumor Wnt-1 as prognostic biomarker may identify patients with HBV- and/or HCV-related HCC patients with a high risk of tumor recurrence who may then benefit from further intensive therapy after surgery. (Cancer Epidemiol Biomarkers Prev 2009;18(5):1562 – 9)