An Estimation System To Predict Prognosis In HCC Patients After Curative Resection, Based On Independent Prognostic Biomarkers And Clinical Factors

The present prognostic systems (e.g. pathological TNM, CLIP etc.) cannot provide a precise prognosis for individuals who undergoing hepatic resection. They are not precise enough because (a) many of the existing studies are retrospective reports describing the results of a given practice without variables related to each specific intervention; (b) they contain variables with only weak prognostic information (epiphenomena) not central to the fundamental biochemical or molecular causes and effects of the disease; (c) they were developed based on histopathologic factors whose determination is prone to variability driven by the quality of sampling and interpretation.In recent years, increasing evidence suggest that the system based on prognostic biomarkers may precisely predict prognosis in HCC patients and several molecules have been proposed as predictive markers for hepatocellular carcinoma. However, no one has been proven clinically useful because (a) most of the studies described were often in small sample size and without a strict selection criteria for subjects; (b) most of the candidate biomarkers and clinical factors were not independent to each other; (c) DNA microarray and RT-PCR not only need high-quality sampling, complex mutistep procedure, but also confer an inherent tendency to produce false positive results; (d) most of them only measure differences at the expression level of gene but not protein.It may be important to distinguish the cellular localization of the gene products, In situ technologies, such as immunohistochemistry (IHC), are optimal for the study of molecular pathology. However, large-scale in situ tissue analyses are cumbersome and slow when traditional methods of molecular pathology are used. To overcome these shortcomings, a tissue microarray (TMA) technique has recently been developed. TMA-based immunohistochemistry is therefore optimally suited for the study of molecular epidemiology.Therefore, we assessed 234 patients who undergo hepatotomy for HCC at Institute of...