Serum manganese superoxide dismutase and thioredoxin are potential prognostic markers for hepatitis C virus-related hepatocellular carcinoma

Figure 1 Serum levels of manganese superoxide dismutase and thioredoxin in the hepatocellular carcinoma, non-hepatocellular carcinoma and healthy volunteer groups. A: Serum manganese superoxide dismutase (MnSOD) levels were significantly higher in the hepatocellular carcinoma (HCC) group than in either the non-HCC group (P = 0.03) or the healthy volunteers (HV) group (P < 0.001); B: Serum thioredoxin (TRX) levels were also significantly higher in the HCC group than in either the non-HCC group (P = 0.04) or the HV group (P < 0.01); C: No significant correlation was detected between serum MnSOD and TRX levels in the HCC group.

Figure 2 Clinical significance of serum manganese superoxide dismutase and thioredoxin levels in hepatocellular carcinoma. In the hepatocellular carcinoma (HCC) group, differences in serum manganese superoxide dismutase (MnSOD) and thioredoxin (TRX) levels were evaluated based on Child-Pugh stage, cancer of the liver italian program (CLIP) score and Japan integrated staging (JIS) score. A: Serum MnSOD levels were significantly higher in patients with Child-Pugh B or C compared to those with Child-Pugh A (P < 0.001); B: Serum MnSOD levels in patients with a CLIP score of 2 or greater were significantly higher compared to levels in patients with a CLIP score of 0 or 1 (P = 0.001); C: In addition, serum MnSOD levels tended to be higher in patients with a JIS score of 2 or greater compared to patients with a JIS score of 0 or 1 (P = 0.05); D-F: In contrast, serum TRX levels were not significantly different based on Child-Pugh stage, CLIP score or JIS score.

Figure 3 Overall hepatocellular carcinoma patient survival based on serum levels of manganese superoxide dismutase or thioredoxin. Overall survival was plotted using the Kaplan-Meier method after separation into two or three groups defined as follows: A: Manganese superoxide dismutase (MnSOD) < 110 ng/mL or ≥ 110 ng/mL; B: Thioredoxin (TRX) < 80 ng/mL or ≥ 80 ng/mL; TRX ≥ 80 ng/mL, TRX < 80 ng/mL; C: MnSOD < 110 ng/mL, or TRX < 80 ng/mL and MnSOD ≥ 110 ng/mL. The overall survival rate was lower in patients with MnSOD levels ≥ 110 ng/mL (P = 0.01) (A). Also, cumulative patient survival rate tended to be lower in patients with TRX levels < 80 ng/mL (P = 0.05) (B). Among these groups, patients with serum TRX levels < 80 ng/mL and serum MnSOD levels ≥ 110 ng/mL had the poorest prognosis (C).