Liver Cancer
Copyright ©2005 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2005; 11(2): 171-175
Published online Jan 14, 2005. doi: 10.3748/wjg.v11.i2.171
Do the expressions of gap junction gene connexin messenger RNA in noncancerous liver remnants of patients with hepatocellular carcinoma correlate with postoperative recurrences?
I-Shyan Sheen, Kuo-Shyang Jeng, Shou-Chuan Shih, Chin-Roa Kao, Po-Chuan Wang, Chih-Zen Chen, Wen-Hsing Chang, Horng-Yuan Wang, Li-Rung Shyung
I-Shyan Sheen, Division of Hepatogastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan, China
Kuo-Shyang Jeng, Departments of Surgery, Mackay Memorial Hospital, Taipei, Taiwan, China
Shou-Chuan Shih, Chin-Roa Kao, Po-Chuan Wang, Chih-Zen Chen, Wen-Hsing Chang, Horng-Yuan Wang, Li-Rung Shyung, Departments of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, China
Kuo-Shyang Jeng, Mackay Medicine, Nursing and Management College, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the Grants From Department of Health, National Science Council, Executive Yuan, Taiwan (NSC-89-2314-B-195-027), China
Correspondence to: Kuo-Shyang Jeng, M.D., F.A.C.S, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec 2, Chung-San North Road, Taipei, Taiwan, China. issheen.jks@msa.hinet.net
Telephone: +886-2-25433535 Fax: +886-2-27065704
Received: May 31, 2004
Revised: June 2, 2004
Accepted: July 5, 2004
Published online: January 14, 2005
Abstract

AIM: To investigate whether the changes of gap junction gene connexin messenger RNA in the noncancerous liver tissue of patients with hepatocellular carcinoma (HCC) could play a significant role in its postresection recurrence.

METHODS: Seventy-nine consecutive patients having undergone curative resection for HCC entered this study. Using a reverse-transcription polymerase chain reaction (RT-PCR)-based assay, connexin (Cx) 26, connexin (Cx) 32 and connexin (Cx) 43 mRNAs were determined prospectively in noncancerous liver tissues from these 79 patients and in the liver tissues from 15 controls. The correlations between connexin mRNA expression and the clinicopathological variables and outcomes (tumor recurrence and recurrence related mortality) were studied.

RESULTS: Compared with liver tissues of control patients, the expression of Cx 32 mRNA in noncancerous liver tissues was significantly lower (mean: 0.715 vs control 1.225, P<0.01), whereas the decreased Cx 26 mRNA (mean: 0.700 vs of control 1.205, P>0.05) and increased Cx 43 mRNA (mean: 0.241 vs control 0.100, P>0.05) had no statistical significance. We defined the value of Cx 32 mRNA or Cx 26 mRNA below 0.800 as a lower value. By multivariate analysis for noncancerous livers, a lower value of Cx 32 mRNA correlated significantly with a risk of HCC recurrence and recurrence-related mortality. The lower value of Cx 26 mRNA did not correlate with recurrence and mortality. The increased value of Cx43 mRNA also did not correlate with postoperative recurrence and recurrence-related mortality. By multivariate analysis, other significant predictors of HCC recurrence included vascular permeation, cellular dedifferentiation, and less encaps-ulation. The other significant parameter of recurrence related mortality was vascular permeation.

CONCLUSION: The decreased expression of Cx 32 mRNA in noncancerous liver tissues plays a significant role in the prediction of postoperative recurrence of HCC.

Keywords: Hepatocellular carcinoma; Gap junctions; Connexins; Local neoplasm recurrences