title: Glypican-3 is a potential prognostic biomarker for hepatocellular carcinoma after curative resection.
abstract: BACKGROUND
  Glypican-3 (GPC3), an oncofetal protein, is overexpressed in hepatocellular carcinoma (HCC). The diagnostic efficacy of GPC3 for HCC has been evaluated intensively in recent years; however, the prognostic value of GPC3 for HCC has not been well clarified. The purpose of this study was to investigate the relationship between GPC3 and postoperative patient survival in a prospective database.
  
  
  METHODS
  GPC3 protein was detected by immunohistochemistry. The relationship between GPC3 expression level and patients' clinicopathologic factors was analyzed. Kaplan-Meier survival analysis was used to calculate patients' survival and was compared by using the log rank test. The Cox regression model was used to identify the risk factors associated with prognosis.
  
  
  RESULTS
  GPC3 was expressed in 84% of HCC tissues. GPC3 protein expression was correlated with the number of tumors (P = .015), serum alpha-fetoprotein (AFP) level (P = .011), and TNM stage (P = .006). High GPC3 expression was an independent risk factor for poor postoperative disease-free survival (hazard ratio [HR] = 0.469; 95% confidence interval [CI] 0.303-0.727; P = .001); and overall survival (HR = 0.435; 95% CI, 0.257-0.736; P = .002). Stratification analysis indicated that GPC3 had a good predictive value for tumor recurrence in patients with HCC who have normal serum AFP levels. Also, GPC3 expression status could predict the outcomes of patients with stage I disease.
  
  
  CONCLUSIONS
  GPC3 is a potential and reliable biomarker for predicting tumor recurrence and overall survival in HCC patients after curative resection.
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Shun-Jun
authors.initials: SJ
authors.lastname: Fu
authors.forename: Chao-Ying
authors.initials: CY
authors.lastname: Qi
authors.forename: Wei-Kai
authors.initials: WK
authors.lastname: Xiao
authors.forename: Shao-Qiang
authors.initials: SQ
authors.lastname: Li
authors.forename: Bao-Gang
authors.initials: BG
authors.lastname: Peng
authors.forename: Li-Jian
authors.initials: LJ
authors.lastname: Liang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D053673:Glypicans / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans; D000509:alpha-Fetoproteins