Is p53 gene mutation an indicatior of the biological behaviors of recurrence of hepatocellular carcinoma?

Table 1 Characteristics of 79 patients with HCC

Characteristics	n (%)
Age (years, mean ± S.D.)	52.4 ± 16.6
Male	52 (65.8)
Liver cirrhosis	57 (72.2)
Child class A:B	55:24 (70:30)
Tumor size small (< 3 cm):	24:25:30 (30.4:31.6:38.0)
median (3-10 cm): large (> 10 cm)
HBsAg (+)	60 (75.9)
Anti-HCV (+)	41 (51.9)
AFP: normal: > 1000 ng/mL	30:20(38.0:25.3)
Edmondson grade: I:II:III:IV	4:30:42:3(5.1:38.0:53.2:3.8)
Capsule: absent: incomplete: complete	54:7:18(68.4:8.9:22.8)
Vascular permeation	56 (70.9)
Daughter nodules	44 (55.7)
Resection, major: minor	55:24 (69.6:30.4)

Notes: HCC: hepatocellular carcinoma; HBsAg: hepatitis B surface antigen; Anti-HCV: antibody to hepatitis C virus; AFP: alpha-fetoprotein; Edmondson grade: Edmondson-Steiner grade of cellular differentiation.

Table 2 Comparison of characteristics between p53 positive and negative groups

Characteristics	P53 Positive(n = 64)	P53 Negative(n = 15)	P (UV)
Age (years)	52.8	48.3	n.s.
Male	65.6%	66.7%	n.s.
Liver cirrhosis	76.6%	53.3%	n.s.
Child class A	68.8%	73.3%	n.s.
Tumor < 3 cm	34.4%	13.3%	n.s.
> 10 cm	35.9%	40.0%	n.s.
HBsAg (+)	78.1%	66.7%	n.s.
Anti-HCV (+)	53.1%	46.6%	n.s.
AFP < 20 ng/mL	37.5%	40.0%	n.s.
> 1000 ng/mL	21.9%	40.0%	n.s.
Edmondson grade Ia	1.6%	20.0%	0.0203
Capsule complete	17.2%	46.7%	0.0346
Daughter nodules	60.9%	33.3%	0.0527
Vascular permeationb	78.1%	40.0%	0.0088

Notes: P (UV): The P value by univariate analysis; In multivariate analysis, the significant variables of

^a and

^b: P values were 0.0120 and 0.0420 respectively; HBsAg: hepatitis B surface antigen; Anti-HCV: antibody to hepatitis C virus; AFP: alpha-fetoprotein; Edmondson grade: Edmondson-Steiner grade of cellular differentiation; n.s.: no statistical significance; O.R.: odds ratio.

Table 3 Correlation of p53 with the outcome of patients with HCC

Outcome	p53 positive(n = 64)	p53 negative (n = 15)	P value
Morbidity of surgery (%)	6.3	6.7	n.s.
Recurrence (%) (number)	76.6 (49)	40.0 (6)	0.0107
Deatha (%)	59.4	33.3	0.0683
Recurrence free interval(median, months)	8.3	39.1	0.0880
Duration of survival(median, months)	11.8	41.9	0.0810

Notes: n.s.: no statistical significance; Death^a: patients died of recurrence.

Table 4 Factors influencing tumor recurrence and death of patients in multivariate analysis

Variables	P	O.R.
Recurrence
Vascular permeation	0.0002	5.36
Complete capsule	0.0160	3.10
p53 positivity	0.0880	2.29
Death
Vascular permeation	< 0.0001	8.35
p53 positivity	0.0810	2.38

Note: O.R: odds ratio.

Table 5 Correlation between the clinical features of recurrent hepatocellular carcinoma and the presence of a p53 mutation in the primary lesion

The clinical features	P53 Positive(n = 49)	P53 Negative(n = 6)	P
Extrahepatic metastasis (number) (%)	24 (49.0)	3 (50.0)	0.1130
Multiple-recurrent tumors (number) (%)	34 (69.4)	4 (66.7)	1.0000
Extent of recurrent tumors:	34 (69.4)	5 (83.3)	0.0043
More than one segment (number) (%)
Median survival after recurrence (Months)	3.4	11.0	0.0510
Treatment for recurrent tumors
Surgery (number) (%)	0	1a (16.7)	n.s.
Non-surgicalb(number) (%)		20 (40.8)	3 (50.0)
No treatment (number) (%)		29 (59.2)	2 (33.3)

Notes: n.s.: no statistical significant;

^a: A 55 year old man had a resection of segment II and III;

^b: The Non-surgical treatments included transcatheter arterial chemoembolization and percutaneous ethanol injection.