title: Comparison of hepatocellular carcinoma in American and Asian patients by tissue array analysis.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Although some epidemiologic and etiologic differences between Asian and Western HCC are known, detailed comparative studies with pathologic correlations have not been performed.
  
  
  METHODS
  Paraffin sections of resected HCC specimens from Memorial Sloan-Kettering Cancer Center and Korea University Medical Center were used to construct tissue microarrays. Immunohistochemical staining of microarray sections was performed using antibodies against markers of proliferation and regulators of cell cycle. Patient data were correlated with staining results.
  
  
  RESULTS
  When comparing both cohorts, significant differences were found in expression of p53 and MDM2. In the Asian group, more frequent positive staining for p53 (24%) was observed compared with the American group (9%; P = 0.037). For MDM2, 26% of American cases stained positive compared with 2% of Asian cases (P = 0.0003). No significant differences were found in expression of Ki67, p21, p27, cyclin D1, or bcl2. Female gender, vascular invasion, and lack of viral hepatitis infection correlated with positive MDM2 staining.
  
  
  CONCLUSIONS
  These data likely correlate with differences in molecular pathogenesis of HCC based on racial and regional differences. These findings may have implications in choice of molecular targeted therapies based on patient ethnicity.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Song
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.forename: Sung-Jin
authors.initials: SJ
authors.lastname: Cho
authors.forename: Mithat
authors.initials: M
authors.lastname: Gönen
authors.forename: Michael
authors.initials: M
authors.lastname: Hezel
authors.forename: Scott
authors.initials: S
authors.lastname: Tuorto
authors.forename: Sang-Yong
authors.initials: SY
authors.lastname: Choi
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Sung-Ock
authors.initials: SO
authors.lastname: Suh
authors.forename: Bum-Hwan
authors.initials: BH
authors.lastname: Koo
authors.forename: Yang-Seok
authors.initials: YS
authors.lastname: Chae
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.forename: David S
authors.initials: DS
authors.lastname: Klimstra
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology*; D019938:Cyclin D1 / Q000032:analysis; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000032:analysis; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008113:Liver Neoplasms / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010232:Paraffin; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D051736:Proto-Oncogene Proteins c-mdm2 / Q000032:analysis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D046888:Tissue Array Analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014481:United States / Q000453:epidemiology
chemical_list: D014408:Biomarkers, Tumor; C530104:CCND1 protein, human; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; C413374:p27 antigen; D019938:Cyclin D1; D010232:Paraffin; C497206:MDM2 protein, human; D051736:Proto-Oncogene Proteins c-mdm2