title: Aberrant expression of monocarboxylate transporter 4 in tumour cells predicts an unfavourable outcome in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  The tumour cell microenvironment, which includes local oxygen saturation, pericellular pH and stromal cells, can modulate tumour progression. This study determined the prognostic impact of infiltrating tumour-associated macrophages and the expression of monocarboxylate transporter 4 (MCT4) and glypican 3 (GPC3) in hepatocellular carcinoma (HCC) clinical specimens.
  
  
  METHODS
  A total of 225 cases of resected HCC were subjected to immunohistochemical analyses of CD68, CD204, MCT4 and GPC3. Immunoreactivities and other common clinicopathological parameters were subjected to univariate prognostic analyses for overall survival (OS, n = 225) and disease-free survival (DFS, n = 222). All variables with prognostic impact were further analysed in multivariate analysis.
  
  
  RESULTS
  Increased intratumoural infiltration of CD204-positive or MCT4-positive macrophages suggested shorter OS (P = 0.015 or P = 0.001 respectively), but DFS was not altered. The GPC3 score (with an emphasis on circumferential immunoreactivity) was correlated with shorter OS and DFS. Aberrant expression of MCT4 in HCC cells was observed in a subset of HCC cases (21%, 47/225). In those cases, significantly poorer OS (P < 0.0001) and DFS (P = 0.0003) were observed, and there was a positive correlation with the intratumoural infiltration of CD204- or MCT4-positive macrophages and the GPC3 score. Multivariate analysis showed that aberrant MCT4 expression in HCC cells was an independent prognostic factor for shorter OS (P = 0.018) and DFS (P = 0.006) after resection of HCC.
  
  
  CONCLUSIONS
  Aberrant expression of MCT4 in carcinoma cells serves as a novel, independent prognostic factor for HCC, indicating a poorer patient outcome.
authors.affiliation: Section of Oncopathology and Regenerative Biology, Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; Pathology Section, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Ohno
authors.forename: Kenji
authors.initials: K
authors.lastname: Yorita
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Haruyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Kato
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ohtomo
authors.forename: Makiko
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Kousuke
authors.initials: K
authors.lastname: Marutuska
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kataoka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D027501:Monocarboxylic Acid Transporters / Q000032:analysis*; D015999:Multivariate Analysis; D009124:Muscle Proteins / Q000032:analysis*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D027501:Monocarboxylic Acid Transporters; D009124:Muscle Proteins; C406962:SLC16A4 protein, human
keywords: MCT4; hepatocellular carcinoma; prognosis; tumour-associated macrophages