Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3774-3785
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3774
Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 is a diagnostic and prognostic biomarker for hepatocellular carcinoma
Yi Cai, Qiao Zheng, De-Jiao Yao
Yi Cai, Qiao Zheng, De-Jiao Yao, Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China
Author contributions: Cai Y and Zheng Q designed the study, data acquisition, data analysis and preparation of the manuscript; Cai Y and Yao DJ revised the manuscript; all authors approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Hospital of Chengdu University of Traditional Chinese Medicine.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: De-Jiao Yao, MD, Professor, Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-qiao Road, Chengdu 610000, Sichuan Province, China. dejiaoy@163.com
Received: April 10, 2020
Peer-review started: April 10, 2020
First decision: June 8, 2020
Revised: June 15, 2020
Accepted: August 4, 2020
Article in press: August 4, 2020
Published online: September 6, 2020
Abstract
BACKGROUND

Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 (P-Rex1) was reported to be a risk factor in several cancers, including breast cancer, lung cancer, and melanoma, but its expression and role in hepatocellular carcinoma (HCC) have not yet been fully studied.

AIM

To explore the expression of P-Rex1 in HCC, and further evaluate its potential application in the diagnosis and prognosis of HCC, especially in hepatitis B virus (HBV)-related patients.

METHODS

P-Rex1 expression in HCC was evaluated by real-time-quantitative polymerase chain reaction. The expression of P-Rex1 was subjected to correlation analysis with clinical features, such as lymph node invasion, distant metastasis, HBV infection, patient's age and gender. Receiver operating characteristic analysis was used to examine the potential role of P-Rex1 as a diagnostic biomarker in HCC. Kaplan-Meier analysis was used to determine the association between P-Rex1 expression and overall survival, progression-free survival and relapse-free survival. Bioinformatic analysis was used to validate the clinical findings.

RESULTS

P-Rex1 expression was significantly increased in HCC tumors than adjacent tissues. The expression of P-Rex1 was higher in HCC patients with lymph node invasion, distant metastasis, HBV infection and positive alpha-fetoprotein, respectively. The receiver operating characteristic analysis showed that P-Rex1 was a diagnostic biomarker with a higher area under the curve value, especially in patients with HBV infection. Survival analysis showed that patients with higher P-Rex1 expression had a favorable survival rate, even in early-stage patients.

CONCLUSION

P-Rex1 expression was highly increased in HCC, and the expression level of P-Rex1 was positively correlated with tumor progression. P-Rex1 has a higher efficiency in the diagnosis of HBV-related HCC, and could also be used as a favorable prognostic factor for HCC patients.

Keywords: Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1, Overexpression, Prognosis, Hepatocellular carcinoma, Hepatitis B virus infection, Diagnosis

Core tip: This study revealed the overexpression of phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 (P-Rex1) in hepatocellular carcinoma (HCC), and the expression level was closely associated with the development of HCC. P-Rex1 is a new diagnostic biomarker for hepatitis B virus-related HCC patients and could serve as a favorable prognostic biomarker in the clinical prediction of HCC.