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Akt phosphorylation is a risk factor for early disease recurrence and poor prognosis in hepatocellular carcinoma
Article first published online: 8 DEC 2004
Copyright © 2004 American Cancer Society
Volume 103, Issue 2, pages 307–312, 15 January 2005
How to Cite
Nakanishi, K., Sakamoto, M., Yamasaki, S., Todo, S. and Hirohashi, S. (2005), Akt phosphorylation is a risk factor for early disease recurrence and poor prognosis in hepatocellular carcinoma. Cancer, 103: 307–312. doi: 10.1002/cncr.20774
- Issue published online: 5 JAN 2005
- Article first published online: 8 DEC 2004
- Manuscript Accepted: 28 SEP 2004
- Manuscript Revised: 21 SEP 2004
- Manuscript Received: 27 APR 2004
- Ministry of Health, Labor, and Welfare of Japan
- Foundation for Promotion of Cancer Research in Japan
- hepatocellular carcinoma;
- early disease recurrence;
- poor prognosis;
- phosphorylated Akt
Patients with hepatocellular carcinoma (HCC) who showed early massive disease recurrence due to hematogenous intrahepatic metastasis after curative resection had a poor prognosis. The authors previously reported that Akt phosphorylation was correlated with hematogenous intrahepatic metastasis, using HCC cell lines.
The authors analyzed clinicopathologic features and the status of selected biologic markers, including phosphorylated Akt, to identify risk factors for early disease recurrence and poor prognosis in HCC. In the current series, 49 postoperative patients developed intrahepatic disease recurrence within 6 months (Group 1) and 86 patients remained disease recurrence free > 3 years after resection (Group 2). Group 1 was further divided into 2 subgroups: 19 patients who died of disease recurrence within a year after resection (Group 1A) and 27 patients who survived > 1 year (Group 1B).
Using univariate analysis, the risk factors for early disease recurrence were tumor size, macroscopic classification, tumor differentiation, microscopic capsule infiltration, microscopic portal vein (MPV) invasion, microscopic intrahepatic metastasis (MIM), and positive immunostaining for phosphorylated Akt, Ki-67, and p53 (P < 0.05). The risk factors for poor prognosis were the number of intrahepatic metastases, tumor differentiation, and positive immunostaining for phosphorylated Akt and Ki-67 (P < 0.05). Multivariate analysis revealed that the risk factors for early disease recurrence were MPV invasion, MIM, and positive immunostaining for phosphorylated Akt, and that the risk factors for poor prognosis were positive immunostaining for phosphorylated Akt and Ki-67 (P < 0.05).
The current clinical study showed the critical involvement of Akt phosphorylation in the aggressiveness of HCC. The potential benefits of surgery should be assessed carefully in patients with any of these risk factors. Cancer 2005. © 2004 American Cancer Society.