Univariate and multivariate analysis of α-methylacyl-CoA racemase (AMACR) and other clinicopathological characteristics at 5 years of follow-up
| Variables | Survival | |||||
|---|---|---|---|---|---|---|
| Univariate analysis | Multivariate analysis | |||||
| HR | 95% CI | p Value | HR | 95% CI | p Value | |
| Age (<55/ ≥55) | 0.743 | 0.488 to 1.132 | 0.167 | |||
| Sex (male/female) | 2.865 | 1.327 to 60 185 | 0.007 | 2.620 | 1.200 to 5.722 | 0.016 |
| HBV infection (absent/present) | 1.411 | 0.929 to 2.142 | 0.106 | |||
| Cirrhosis (absent/present) | 1.054 | 0.770 to 1.442 | 0.744 | |||
| Alanine transaminase (ALT) (U/L) (<54/≥54) | 1.167 | 0.781 to 1.745 | 0.451 | |||
| Total bilirubin (μmol/L) (<25/≥25) | 0.765 | 0.386 to 1.519 | 0.445 | |||
| GGTP (U/L) (<60/≥60) | 1.634 | 0.991 to 2.696 | 0.054 | |||
| Prothrombin time (s) (≤14/>14) | 0.985 | 0.626 to 1.549 | 0.946 | |||
| Dissemination to regional lymph nodes (absent/present) | 2.280 | 0.993 to 5.234 | 0.052 | |||
| Tumour boundaries (distinct/indistinct) | 1.417 | 0.737 to 2.723 | 0.296 | |||
| Intraoperative ascites (absent/present) | 1.628 | 1.050 to 2.524 | 0.030 | 1.251 | 0.776 to 2.015 | 0.358 |
| Tumour number (single/multiple) | 0.992 | 0.530 to 1.857 | 0.980 | |||
| Maximal tumour size(<5/≥5) | 4.439 | 1.084 to 10.925 | 0.001 | 2.368 | 0.931 to 6.026 | 0.070 |
| Tumour encapsulation (absent/present) | 1.833 | 1.203 to 2.795 | 0.005 | 1.301 | 0.822 to 2.058 | 0.262 |
| Tumour differentiation (I/II–III) | 0.258 | 0.105 to 0.635 | 0.003 | 0.418 | 0.167 to 1.050 | 0.063 |
| Extrahepatic metastasis (yes/no) | 0.851 | 0.505 to 1.434 | 0.544 | |||
| PVTT (absent/present) | 2.280 | 1.505 to 30 454 | 0.000 | 1.801 | 1.169 to 2.773 | 0.008 |
| AMACR (low expression/high expression) | 0.501 | 0.326 to 0.770 | 0.002 | 0.612 | 0.319 to 0.957 | 0.031 |
Prognostic significance of AMACR: univariable analysis revealed that presence of intraoperative ascites and PVTT, maximal tumour size ≥5 cm, absence of tumour encapsulation, poor differentiation, low expression of AMACR were significantly associated with poor prognosis. On multivariate analysis of the prognostic factors for overall survival, presence of PVTT (relative risk (RR)=1.801; 95% CI 1.169 to 2.773; p=0.008) and low expression of AMACR (RR=0.612; 95% CI 0.319 to 0.957; p=0.031) were independent predictors for poor overall survival of hepatocellular carcinoma patients.
GGTP, glutamyltranspeptidase; HBV, Hepatitis B virus; PVTT, portal vein tumour thrombosis.