Published online Jun 27, 2026. doi: 10.4240/wjgs.116682
Revised: February 7, 2026
Accepted: April 1, 2026
Published online: June 27, 2026
Processing time: 159 Days and 11 Hours
Transarterial chemoembolization (TACE) is a standard treatment for recurrent hepatocellular carcinoma (HCC) after liver resection. However, resistance to TACE considerably limits its efficacy and worsens patient prognosis. Identifying molecular markers that predict TACE response is crucial for individualized treatment strategies.
To investigate lipoma HMGIC fusion partner-like 2 (LHFPL2) expression in patients with HCC and its association with TACE efficacy and overall survival (OS).
A retrospective study was conducted including 60 patients with HCC who underwent ≥ 3 standardized TACE treatments for recurrence after curative hepatectomy between January 2014 and December 2020 at Jiangsu Provincial People’s Hospital and Wuxi People’s Hospital. The patients were divided into TACE-resistant (n = 30) and non-resistant (n = 30) groups. LHFPL2 protein expression in tumor tissues was assessed using immunohistochemistry, and its association with clinicopathological features, TACE response, and OS was ana
The TACE-resistant group exhibited significantly higher LHFPL2 expression than the non-resistant group (P < 0.05). Significant differences were observed between the two groups in hepatitis B virus carrier status, alpha-fetoprotein (AFP) levels, tumor differentiation, and LHFPL2 expression (P < 0.05). The median OS in the LHFPL2 high-expression group was 2.28 years, which was significantly shorter than that in the low expression group (P < 0.05). Multivariate Cox regression analysis indicated that high LHFPL2 expression, AFP ≥ 400 ng/mL, and TACE resistance were independent risk factors for OS (P < 0.05). A combined prognostic model using LHFPL2 and AFP revealed that patients with high LHFPL2 and AFP ≥ 400 ng/mL had the poorest prognosis (median OS 1.44 years), whereas patients with low LHFPL2 and AFP < 400 ng/mL had the best prognosis (median OS not reached), with significant differences (P < 0.05).
High LHFPL2 expression was closely associated with TACE resistance and was an independent predictor of poor prognosis in patients with HCC. Combining LHFPL2 with AFP enhanced prognostic stratification, providing a novel molecular marker and clinical basis for personalized therapy and TACE response prediction.
Core Tip: Lipoma HMGIC fusion partner-like 2 overexpression contributes to transarterial chemoembolization resistance in hepatocellular carcinoma patients and predicts unfavorable outcomes. The combination of lipoma HMGIC fusion partner-like and alpha-fetoprotein levels allows for improved prognostic assessment, offering a potential molecular marker for individualized treatment planning and early identification of transarterial chemoembolization non-responders (No. AF-SW-07-02.1).