Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 is a diagnostic and prognostic biomarker for hepatocellular carcinoma

Figure 1 Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 messenger ribonucleic acid expression was increased in liver cancer tissues compared with adjacent normal tissues. A: Ninety resected liver tumor tissues and adjacent normal liver tissues were subjected to real-time quantitative polymerase chain reaction to determine the messenger ribonucleic acid level of P-Rex1; and B: The expression ratio between tumor tissues and normal liver tissues in 90 resected samples, the ratio was assessed by log treatment. ^cP < 0.001 was considered significantly different. P-Rex1: Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1; T: Liver tumor; N: Normal liver.

Figure 2 P-Rex1 levels were closely associated with the pathological features of hepatocellular carcinoma. A: The P-Rex1 expression level in patients with HBV infection; B: lymph node invasion; C: distant metastasis; and D: alpha-fetoprotein levels were determined, respectively. ^cP < 0.001 was considered significantly different compared with the negative groups, respectively. P-Rex1: Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1; HBV: Hepatitis B virus; AFP: Alpha-fetoprotein.

Figure 3 Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 was a good diagnostic biomarker for hepatocellular carcinoma, especially in patients with hepatitis B virus infection. A: A total of 90 hepatocellular carcinoma tissues were subjected to receiver operating characteristic (ROC) analysis. The phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 (P-Rex1) expression in the liver tumor was set as the patient group, and adjacent normal tissues was set as the control group; B: The patients with different alpha-fetoprotein levels were subjected to ROC analysis based on the P-Rex1 expression; C: The correlation between alpha-fetoprotein and P-Rex1 expression was analyzed in 90 liver tumor tissues; and D: Patients with and without hepatitis B virus infection were subjected to ROC analysis based on P-Rex1 expression. ROC: Receiver operating characteristic; 95%CI: 95% confidence interval; AUC: Area under the curve; AFP: Alpha-fetoprotein. P-Rex1: Phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1.

Figure 4 Validation of phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 expression in the cancer genome atlas and human protein atlas database. A: The expression of phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 (P-Rex1) in hepatocellular carcinoma liver tumor tissues and adjacent normal tissues in the cancer genome atlas were subjected to analysis; B: The protein expression of P-Rex1 in liver tumor tissue and normal liver tissue was determined by the human protein atlas database; and C: The immunohistochemistry score of P-Rex1 in panel B was quantified by Quantity One software. ^cP < 0.001 was considered significantly different compared with normal liver tissues. TCGA: The cancer genome atlas; HCC: Hepatocellular carcinoma.

Figure 5 Survival analysis was conducted in hepatocellular carcinoma patients with high or low phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 expression. A: Using the cancer genome atlas, hepatocellular carcinoma patients were subjected to overall survival analysis; B: Progression-free survival; and C: Relapse-free survival in those with high or low phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 expression. The median level was applied to patient clustering. HR: Hazard ratio.

Figure 6 The overall survival, progression-free survival, relapse-free survival analysis of phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 in early-stage hepatocellular carcinoma patients. A: Hepatocellular carcinoma patients with T1 stage based on the American Joint Committee on Cancer were included in the overall survival analysis, B: Progression-free survival analysis, C: Relapse-free survival analysis according to the phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 expression; D: The overall survival analysis, E: Progression-free survival analysis, and F: Relapse-free survival analysis of phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1 was assessed in hepatocellular carcinoma patients with stage 1. OS: Overall survival; PFS: Progression-free survival; RFS: Relapse-free survival; AJCC-T1: T1 stage based on the American Joint Committee on Cancer; HR: Hazard ratio.