title: Preoperative serum retinol-binding protein 4 is associated with the prognosis of patients with hepatocellular carcinoma after curative resection.
abstract: OBJECTIVE
  Metabolic syndrome and insulin resistance have been linked to increased risk of occurrence and mortality of hepatocellular carcinoma (HCC). Recently, retinol-binding protein 4 (RBP4) was clarified as a specific serological marker of insulin resistance. The aim of this study was to determine whether serum RBP4 could be used as a potential marker for predicting prognosis in patients with HCC after curative resection.
  
  
  METHODS
  Western immunoblotting and Enzyme-linked immunosorbent assay were used to measure the RBP4 expression in cell lines, supernatant, and serum. Serum RBP4 levels were compared with clinicopathological features and outcomes of patients with HCC. Furthermore, we investigated the impact of serum RBP4 level, serum C-peptide level, and HOMA-IR on overall survival (OS) and disease-free survival (DFS) of patients with HCC in the training cohort (156 patients with HCC), and then were validated in the validation cohort (105 patients with HCC).
  
  
  RESULTS
  RBP4 protein overexpressed in HCC cell lines compared with normal liver cell line (P < 0.001) and correlated with metastatic potential. Serum RBP4 levels were associated with OS [hazard ratio (HR) = 2.208, P < 0.001] and DFS (HR = 1.878, P = 0.029) of patients with HCC. By multivariate analysis, the serum RBP4 level was identified as an independent factor for OS (HR = 2.170, P = 0.004) and DFS (HR = 1.769, P = 0.037) of patients with HCC. The prognostic value of serum RBP4 level was confirmed in the validation cohort.
  
  
  CONCLUSIONS
  The serum RBP4 level is potential to be a useful prognostic factor for HCC after curative resection.
authors.affiliation: Department of Endocrinology, Punan Hospital, Shanghai 200125, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Wang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Zhao
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Guang
authors.initials: G
authors.lastname: Ren
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.forename: Zu-Guang
authors.initials: ZG
authors.lastname: Xia
authors.forename: Xi-Long
authors.initials: XL
authors.lastname: Wang
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.forename: Qi
authors.initials: Q
authors.lastname: Pan
authors.forename: Zhi
authors.initials: Z
authors.lastname: Dai
authors.forename: Ju-Ping
authors.initials: JP
authors.lastname: Chen
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Dai
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: He
authors.forename: Jia-Min
authors.initials: JM
authors.lastname: Zhou
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Tang
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.forename: Zhao-You
authors.initials: ZY
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000601:surgery; D045744:Cell Line, Tumor; D005260:Female; D006801:Humans; D008099:Liver / Q000737:chemistry; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D054839:Retinol-Binding Proteins, Plasma / Q000032:analysis*; D012189:Retrospective Studies
chemical_list: C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma