Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. May 19, 2026; 16(5): 117187
Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.117187
Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.117187
Alcohol dehydrogenase 4 expression in hepatocellular carcinoma and its association with tumor invasion, survival, and psychological status
Tian Xia, Cheng-Li Liu, Department of Hepatobiliary Surgery, Air Force Medical Center, Graduate School of Hebei North University, Hebei North University, Zhangjiakou 075031, Hebei Province, China
Cheng-Li Liu, Pu Meng, Ying-Bo Ma, Qi-Ke Huang, Hao-Ming Li, Xu-Ying Zhao, Cheng Wang, Gang Zhao, Ling-Hong Kong, Department of Hepatobiliary Surgery, Air Force Medical University, Air Force Medical Center, Beijing 100142, China
Jing-Chen Zhang, Department of Hepatobiliary Surgery, Air Force Medical Center, Graduate School of Hebei North University, Zhangjiakou 075031, Hebei Province, China
Author contributions: Xia T was primarily responsible for data collection, analysis, statistical evaluation, and manuscript drafting; Liu CL contributed to the study design, manuscript revision, and final review; Zhang JC, Meng P, Ma YB, Huang QK, Li HM, Zhao XY, Wang C, Zhao G and Kong LH contributed to data interpretation, and manuscript refinement; all of the authors read and approved the final version of the manuscript to be published.
Supported by Capital Health Development Research Special Project of 2024, No. SF-2024-2-5121.
Institutional review board statement: This study was approved by the Ethics Committee of the Air Force Medical Center (No. 2024-42-PJ01). All procedures were conducted in accordance with the Declaration of Helsinki and relevant institutional guidelines.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The data analyzed in this study can be obtained from the corresponding author upon reasonable request.
Corresponding author: Cheng-Li Liu, MD, Department of Hepatobiliary Surgery, Air Force Medical Center, Graduate School of Hebei North University, Hebei North University, No. 11 Diamond South Road, Qiaodong District, Zhangjiakou 075031, Hebei Province, China.
Received: December 9, 2025
Revised: January 9, 2026
Accepted: February 12, 2026
Published online: May 19, 2026
Processing time: 141 Days and 0.6 Hours
Revised: January 9, 2026
Accepted: February 12, 2026
Published online: May 19, 2026
Processing time: 141 Days and 0.6 Hours
Core Tip
Core Tip: Low alcohol dehydrogenase 4 (ADH4) expression in hepatocellular carcinoma correlates with larger tumors, poor differentiation, high microvascular invasion, reduced 1-year and 3-year survival, and elevated anxiety-depression scores. Multivariate analysis identifies low ADH4 as an independent poor prognostic factor. These findings suggest ADH4 is a valuable biomarker for assessing tumor aggressiveness, predicting outcomes, and identifying patients requiring intensive therapy and psychosocial support, thus enabling personalized oncological and mental-health interventions to improve overall prognosis and quality of life.