title: Reduced expression of C/EBP alpha protein in hepatocellular carcinoma is associated with advanced tumor stage and shortened patient survival.
abstract: OBJECTIVE
  CCAAT/enhancer binding protein alpha (C/EBP alpha) is a transcription factor and a tumor suppressor. We aimed to assess its protein expression and prognostic value in human hepatocellular carcinoma (HCC).
  
  
  METHODS
  We conducted a retrospective cohort study on 50 HCC patients and performed immunohistochemistry against C/EBP alpha on tumors and adjacent nontumor specimens. Relationships of C/EBP alpha expression with clinical parameters and patient survival were analyzed.
  
  
  RESULTS
  C/EBP alpha expression was not influenced by chronic alcohol exposure, viral hepatitis, or cirrhosis, but was reduced in 60% of HCC. Reduction of C/EBP alpha was associated with advanced tumor stage (P = 0.001). Patients with markedly reduced C/EBP alpha expression had a significantly shorter survival with a hazard ratio of 5.45 (95% confidence interval, 1.93-15.40; P = 0.001).
  
  
  CONCLUSIONS
  C/EBP alpha may be a potential prognostic marker or therapeutic target in HCC regardless of different etiology.
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Hsi-Huang
authors.initials: HH
authors.lastname: Tseng
authors.forename: Yaw-Huei
authors.initials: YH
authors.lastname: Hwang
authors.forename: Kun-Tu
authors.initials: KT
authors.lastname: Yeh
authors.forename: Jan-Gowth
authors.initials: JG
authors.lastname: Chang
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
authors.forename: Hsin-Su
authors.initials: HS
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D022763:CCAAT-Enhancer-Binding Protein-alpha / Q000235:genetics*; D006528:Carcinoma, Hepatocellular / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002648:Child; D015331:Cohort Studies; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
chemical_list: D022763:CCAAT-Enhancer-Binding Protein-alpha