Analysis of NQO1 polymorphisms and p53 protein expression in patients with hepatocellular carcinoma

NAD(P)H: quinone oxidoreductase 1 (NQO1), a cytosolic enzyme which catalyzes the twoelectron reduction of quinone compounds, has been suggested to prevent the generation of semiquinone free radicals and reactive oxygen species, thus protecting cells from oxidative damage. However, the enzymatic activity of NQO1 strongly depends on the individual genetic polymorphism of the NQO1 gene. A common NQO1 polymorphism is a C to T transition at position 609, which results in an inactive enzyme. Recent studies showed that NQO1 is an important enzyme for stabilizing p53 protein, which is involved in antitumorigenesis. Thus, the lack of enzymatic activity in the homozygous C609T NQO1 polymorphism may play a pivotal role in tumor development. This study aimed to investigate the relationship between C609T NQO1 polymorphism and p53 expression in human hepatocellular carcinoma (HCC). Genotyping of NQO1 was performed on 100 HCC specimens by PCR-RFLP analysis. In addition, NQO1 and p53 protein expression in HCC samples at different TNM stages was determined by immunohistochemistry. Our data showed that (1) the frequency of C609T NQO1 was significantly increased in TNM stage III HCC patients; (2) no significant association was found between p53 expression and C609T polymorphism of NQO1 gene; and (3) a tumor/non-tumor (T/N) ratio > 1.27 of NQO1 expression revealed by real-time qPCR analyses was positively correlated with poorer survival in patients with tumors >5 cm, suggesting that an increase of NQO1 expression may be an indicator of advanced tumor progression. This study provides important information about NQO1 genotypes and its expression to HCC tumor development and progression

Risk of recurrence in chronic hepatitis B patients developing hepatocellular carcinoma with antiviral secondary prevention failure

<div><p>Background</p><p>Nucleos(t)ide analogues (NUCs) treatment can reduce the risk of hepatocellular carcinoma (HCC) development and recurrence in chronic hepatitis B (CHB) patients. However, the risk of recurrence in CHB patients who develop HCC despite NUC treatment remains unclear.</p><p>Methods</p><p>167 consecutive CHB patients receiving curative resection for HCC with NUC therapy after surgery were retrospectively enrolled. Thirty-eight patients who developed HCC despite NUC therapy for more than 1 year were defined as secondary prevention failure. The other 129 patients started NUC therapy after surgery. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were evaluated.</p><p>Results</p><p>The 5-year RFS and OS rates were 44.7% and 77.3%, respectively. Sex, BMI, BCLC stage, AFP levels and cirrhosis status were the independent predictors of RFS, while microvascular invasion was the independent predictor of OS. The RFS was comparable between patients with and without NUC secondary prevention. In the subgroup analysis, the RFS was significantly worse in cirrhotic patients with secondary prevention failure (hazard ratio = 2.373, p = 0.009). Secondary prevention failure did not have adverse impact on OS. Among 84 patients with recurrence, 58.3% of the cases remained in BCLC stage A, and 53.6% received a second curative treatment. Long-term NUC therapy may lead to a decline of non-invasive indices of hepatic fibrosis in HCC patients.</p><p>Conclusions</p><p>In general, the risk of recurrence and survival are comparable between patients with and without secondary prevention failure. However, a higher risk of recurrence was observed in cirrhotic patients with secondary prevention failure.</p></div