Expression And Prognostic Value Of Spindle And Kinetochore-associated Complex Subunit 1 In Hepatocellular Carcinoma

Background: Hepatocellular carcinoma(HCC)is a common malignant tumor in the digestive system.Although a large number of studies have reported the underlying mechanism of HCC development,an optimum prognostic marker has not yet been found.The purpose of this study was to analyze the expression and prognostic value of spindle and kinetochore-associated complex subunit 1(SKA1)in hepatocellular carcinoma.Methods: 1.SKA1 expression was evaluated by immunohistochemistry method in 88 pairs of HCC and adjacent tumor-free tissues;2.The expression was confirmed through mining the publical available database The Cancer Genome Atlas(TCGA);3.Chi-square test was used to analyze the relationship between SKA1 expression and clinicopathological parameters of HCC patients.Spearsman correlation was used to analyze the correlation between SKA1 expression and tumor size;4.Kaplan-Meier method was used to analyze the effect of SKA1 expression on the overall survival rate and disease-free survival rate of patients,and TCGA database was excavated to verify the effect of SKA1 on the overall survival rate of patients;5.Kaplan-Meier method was used to conduct subgroup analysis which analyzes the effect of SKA1 expression level combined with clinicopathological parameters on the overall survival rate and disease-free survival rate of patients;6.The effects of SKA1 expression on overall survival and disease-free survival were analyzed by univariate and multivariate Cox proportional hazard regression model.Results: 1.Immunohistochemical results showed that the expression level of SKA1 in cancer tissues was significantly higher than that in corresponding adjacent tissues(P < 0.001);2.TCGA database showed that SKA1 expression in HCC tissues was obviousely overexpressed compared with that in normal hepatic tissues(P < 0.001);3.SKA1 expression was not correlated with sex,age,hepatitis B virus surface antigen positive,alanine aminotransferase,alpha-fetoprotein,liver cirrhosis,tumor number,tumor encapsulation and differentiation(P > 0.05),but with tumor size(P = 0.002),and the Spearman correlation coefficient of SKA1 expression with tumor size was 0.334(P = 0.001);4.The overall survival rate of patients with high expression of SKA1 was lower than that of patients with low expression of SKA1(P < 0.001),and the disease-free survival rate of patients with high expression of SKA1 was lower than that of patients with low expression of SKA1(P = 0.016);5.Subgroup analysis showed that high SKA1 expression predicted overall survival and disease-free survival only for high alanine transaminase level(P < 0.001,P = 0.007),with no statistical significance in the difference for low alanine transaminase level(P = 0.115,P = 0.605);6.Univariate survival analysis showed that the factors influencing the overall survival rate of HCC patients were SKA1 expression,tumor number,alanine transaminase and tumor size.SKA1 expression,tumor number and alanine transaminase were independent risk factors for overall survival of HCC patients.SKA1 expression,tumor number,alanine transaminase and tumor size were the factors affecting the disease-free survival rate of HCC patients.Multivariate survival analysis showed that SKA1 expression was not an independent risk factor for disease-free survival rate of HCC patients.Alanine transaminase and tumor number were independent risk factors for disease-free survival rate of HCC patients.Conclusions: 1.Compared to adjacent tissues,SKA1 was overexpressed in HCC;2.SKA1 expression was positively correlated with tumor size;3.Overall survival and disease-free survival were low in patients with high SKA1 expression;4.High SKA1 expression could predict overall survival and disease-free survival in patients with high plasma alanine transaminase;5.SKA1 is an independent risk factor for overall survival of HCC,but not for disease-free survival.