title: The prognostic value of combined TGF-β1 and ELF in hepatocellular carcinoma.
abstract: BACKGROUND
  Tumor suppression of Transforming Growth Factor (TGF-β) signaling pathway requires an adaptor protein, Embryonic Liver Fodrin (ELF). Disruption of ELF expression resulted in miscolocalization of Smad3 and Smad4, then disruption of TGF-β signaling. However, the prognostic significance of ELF for hepatocellular carcinoma (HCC) hasn't been clarified. This study aimed to investigate whether measuring both TGF-β1 and ELF provides a more powerful predictor for HCC prognosis than either marker alone.
  
  
  METHODS
  TGF-β1 and ELF protein were detected by immunohistochemistry. The relationship between TGF-β1/ELF expression and patients' clinicopathologic factors was analyzed. The association between TGF-β1/ELF expression and disease-free survival and overall survival was analyzed by Kaplan-Meier curves, the log-rank test, and Multivariate Cox regression analyses.
  
  
  RESULTS
  The expression of TGF-β1 in HCC tissues was significantly higher than that in normal liver tissues. Conversely, the expression of ELF in HCC tissues declined markedly. ELF protein was correlated with HBsAg, tumor size, tumor number, TNM and recurrence. Data also indicated a significant negative correlation between ELF and TGF-β1. Patients with high TGF-β1 expression or/and low ELF expression appeared to have a poor postoperative disease-free survival and overall survival compared with those with low TGF-β1 expression or/and high ELF expression. Furthermore, the predictive range of ELF combined with TGF-β1 was more sensitive than that of either one alone.
  
  
  CONCLUSIONS
  TGF-β1 and ELF protein are potential and reliable biomarkers for predicting prognosis in HCC patients after hepatic resection. Our current study has demonstrated that the prognostic accuracy of testing can be enhanced by their combination.
authors.affiliation: Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. jifei1215@163.com.
authors.forename: Fei
authors.initials: F
authors.lastname: Ji
authors.affiliation: Department of Hepatopancreaticobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of TCM), Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 510120, P. R. China. fsj103@163.com.
authors.forename: Shun-Jun
authors.initials: SJ
authors.lastname: Fu
authors.affiliation: Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. shunlishen@163.com.
authors.forename: Shun-Li
authors.initials: SL
authors.lastname: Shen
authors.affiliation: Laboratory of Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. zhlongj@mail.sysu.edu.cn.
authors.forename: Long-Juan
authors.initials: LJ
authors.lastname: Zhang
authors.affiliation: Department of Pathology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. bpigeon@163.com.
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Cao
authors.affiliation: Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. Lisq@medmail.com.cn.
authors.forename: Shao-Qiang
authors.initials: SQ
authors.lastname: Li
authors.affiliation: Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. pengbaogang@medmail.com.cn.
authors.forename: Bao-Gang
authors.initials: BG
authors.lastname: Peng
authors.affiliation: Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. dr_lianglj@163.com.
authors.forename: Li-Jian
authors.initials: LJ
authors.lastname: Liang
authors.affiliation: Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China. hyp0427@163.com.
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Hua
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002352:Carrier Proteins / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D015398:Signal Transduction; D053773:Transforming Growth Factor beta1 / Q000378:metabolism*; D047368:Tumor Burden; D055815:Young Adult; D013049:Spectrin
chemical_list: D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D008840:Microfilament Proteins; D053773:Transforming Growth Factor beta1; D013049:Spectrin