The autophagy marker LC3 strongly predicts immediate mortality after surgical resection for hepatocellular carcinoma

Chih Wen Lin, Chih Che Lin, Po Huang Lee, Gin Ho Lo, Pei Min Hsieh, Kah Wee Koh, Chih Yuan Lee, Yao Li Chen, Chia Yen Dai, Jee Fu Huang, Wang Long Chuang, Yaw Sen Chen, Ming Lung Yu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

14 Scopus citations

Abstract

The remnant liver's ability to regenerate may affect post-hepatectomy immediate mortality. The promotion of autophagy post-hepatectomy could enhance liver regeneration and reduce mortality. This study aimed to identify predictive factors of immediate mortality after surgical resection for hepatocellular carcinoma (HCC). A total of 535 consecutive HCC patients who had undergone their first surgical resection in Taiwan were enrolled between 2010 and 2014. Clinicopathological data and immediate mortality, defined as all cause-mortality within three months after surgery, were analyzed. The expression of autophagy proteins (LC3, Beclin-1, and p62) in adjacent non-tumor tissues was scored by immunohistochemical staining. Approximately 5% of patients had immediate mortality after surgery. The absence of LC3, hypoalbuminemia (< 3.5 g/dl), high alanine aminotransferase, and major liver surgery were significantly associated with immediate mortality in univariate analyses. Multivariate logistic regression demonstrated that absence of LC3 (hazard ratio/95% confidence interval: 40.8/5.14-325) and hypoalbuminemia (2.88/1.11- 7.52) were significantly associated with immediate mortality. The 3-month cumulative incidence of mortality was 12.1%, 13.0%, 21.4% and 0.4%, respectively, among patients with absence of LC3 expression, hypoalbuminemia, both, or neither of the two. In conclusion, the absence of LC3 expression in adjacent non-tumor tissues and hypoalbuminemia were strongly predictive of immediate mortality after resection for HCC.

Original languageEnglish
Pages (from-to)91902-91913
Number of pages12
JournalOncotarget
Volume8
Issue number54
DOIs
StatePublished - 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Lin et al.

Keywords

  • Albumin
  • Autophagy
  • Liver failure
  • Post-hepatectomy immediate mortality
  • Predictor

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