| ObjectiveTo explore the expression of MALAT1(metastasis-associated lung adenocarcinoma transcript 1)mRNA in primary HCC(hepatocellular carcinoma)tissue,the relationship between the expression of MALAT1 and clinical pathological features of HCC patients,and the correlation between MALAT1 and prognosis of hepatocellular carcinoma patients after radical operation was analysised.That may provide a clinical reference for searching a biomarker which could be used to evaluate the prognosis for HCC patients.MethodsUsed qRT-PCR method for the detection of MALAT1 in 169 cases of liver cancer patients undergoing surgical resection of cancer tissue,and 21 cases of HCC tissues expression levels.Take GAPDH as the internal reference,Calculated MALAT1 relative expression values.SPSS 19.0 statistical software was applied for data analysis.The correlations between the expression of MALAT1 and the clinical pathological characteristics of HCC ?the time of recurrence and metastasis?overall survival,were analyzed by t-test or ANOVA.The comparison of rate used chi-square test.Kaplan-Meier method was used to computed survival univariate analysis.The differences between groups were analyzed by Log-rank test.The conventional prognostic factors were analyzedby Cox regression model.A p-value less than 0.05 was condidered significantly.Results1?The follow-up period ended up to March 12,2017,there were 121 HCC patients with complete follow-up data,the longest follow-up for 128 months,the shortest for 8 months,the median follow-up time was 59 months.Recurrence and metastasis occurred in 58 cases,the recurrence rate was 47.9%,the median time to recurrence was 12 months.At the end of the follow-up,64 cases survived and 57 cases died.2?The MALAT1 relative expression(mean±SD)in 169 HCC tissues was3.58±5.45,The MALAT1 relative expression of in 21 cases of the adjacent tissues was 0.58±1.55,the difference was statistically significant(P<0.05).Moreover,the expression of MALAT1 in HCC tissues was significantly higher than that in the corresponding adjacent tissues.The difference was also statistically significant(P<0.05).3?The expression of MALAT1 in HCC was significantly correlated with vascular tumor thrombus(P<0.05).However,the expression of MALAT1 in HCC was not significantly correlated with age,gender,nationnality,alcohol hobby,smoking,family medical history,preoperative serum of ALT?AST?TB?AFP,Child–Pugh score,chronic hepatitis-b history,liver cirrhosis,number of tumor mass,size of tumor mass,TNM and BCLC stage,respectively(P>0.05,respectively).4?In the 57 patients who recurrenced and metastased,the MALAT1 high expression group,s Disease-free survival time(mean±SD)were 15.25±13.83 months,significantly shorter than MALAT1 low expression group,s;The DFS within MALAT1 high group plus middle group were 16.70±16.44 months,aslo significantly shorter than that of MALAT1 low expression group;thedifferences were both statistically significant(P < 0.05).Compared the expressions of MALAT among the recurrence and metastasis time?12M,12M~24M,24M~groups,the difference was statistically significant(P<0.05).Respectively compared the expression of MALAT1 between recurrence and metastasis time ?12M group and>12M group,?24M group and>24M group,?36M group and>36M group,the fomers were significantly higher than the latters,the difference was statistically significant(P<0.05).5?In the 121 HCC patients with complete follow-up data,Compared the expressions of MALAT among the recurrence and metastasis time?12M,12M~24M,24M~36M?36M~48M?48M~60M?60M~groups,the difference was statistically significant(P<0.05).Respectively compared the expression of MALAT1 between recurrence and metastasis time ?60M group and > 60 M group,?72M group and > 72 M group,the fomers were significantly higher than the latters,the differences were statistically significant(P<0.05).6?In the 57 patients who died,the expression of MALAT1 in overall survival(OS)?48M group was significantly higher than the OS?48M group,the difference was statistically significant(P<0.05).7?In the 121 HCC patients with complete follow-up data,Compared the expression of MALAT1 among OS?12M,12M~24M,24M~36M,36M~48M,48M~60M,60M~72M,72M~84M and > 84 M groups,the difference was statistically significant(P<0.05).The expression of MALAT1 in OS?12M group,12M~24M group,24M~36M group and > 36 M group decreased gradually,but the difference was no statistically significant(P <0.05).Respectively compared the expression of MALAT1 between OS?60M group and>60M group,?72M group and>72M group,?8M 4group and>84M group,the fomers was significantly higher than the latters,the difference was statistically significant(P<0.05).In 121 HCC cases,the 5-year and6-year survival rates of high expression group were 11.6%(5/43)?9.3%(4/43),and those of low expression group were 51.5%(17/33)?42.4%(14/33),the5-year and 6-year survival rates of high expression group were significantly lower than low expression group,the difference was statistically significant(P<0.05).8?Univariate analysis showed that chronic hepatitis-b history,preoperative serum of AST,size of tumor mass,are risk factors for recurrence and metastasis of HCC after radical resection.The cumulative rate of recurrence and metastasis within 3 years in group with chronic hepatitis-b(49.5%)was significantly higher than that in the group without chronic hepatitis-b(23.5%);The cumulative rate of recurrence and metastasis within 3 years in preoperative serum of AST >40U/L group(56.9%)was significantly higher than that in preoperative serum of AST?40U/L group(28.6%);The cumulative rate of recurrence and metastasis within 3 years in tumor?5cm group(50.7%)was significantly higher than the tumor < 5cm group(31.5%).The differences were statistically significant(P<0.05).The multivariate COX regression model analysis showed that the independent risk factors for post-operation relapse and metastasis in patients with hepatocellular carcinoma after radical resection included chronic hepatitis-b history,preoperative serum of AST.9?Univariate analysis showed that preoperative serum of AST,number of tumor mass,TNM stage,were risk factors for OS of HCC after radical resection.The 4-year survival rate in preoperative serum of AST>40U/L group(47.9%)was significantly lower than that in the serum of AST>40U/L group(77.2%);The 4-year survival rate in Multiple-tumor group(43.5%)was significantlylower than that in the single-tumor group(67.6%);In TNM stage,The 4-year survival rates of phaseI,phase II and phase III were 68.0%?50.0%?41.7%,respectively.The differences above were statistically significant(P<0.05).The multivariate COX regression model analysis showed that preoperative serum of AST was an independent risk factor for OS in patients with hepatocellular carcinoma after radical resection.Conclusion1?The expression of MALAT1 mRNA in HCC tissues was significantly higher than that in the adjacent tissues.2?The expression level of MALAT1 in HCC was significantly correlated with vascular tumor thrombus.The expression of MALAT1 in HCC was not significantly correlated with age,gender,nationnality,alcohol hobby,smoking,family medical history,preoperative serum of ALT?AST?TB?AFP,Child–Pugh score,Chronic hepatitis-b,Liver cirrhosis,number of tumor mass,size of tumor mass,TNM and BCLC staging,respectively(P>0.05,respectively).3?The increased expression of MALAT1 in HCC tissues suggests that it is prone to the recurrence and metastasis after surgery,and perhaps could be used as an indicator for predicting the risk of recurrence after radical surgery for HCC patients.4 ? HCC patiens with higher MALAT1 expression have shorter overall survival than HCC patiens with lower MALAT1 expression.5?Chronic hepatitis history,preoperative serum of AST and size of tumor mass were the independent risks factors for post-operation relapse and metastasis in patients with hepatocellular carcinoma after radical resection included.6?Preoperative serum of AST was an independent risk factor for OS inpatients with hepatocellular carcinoma after radical resection. |
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