title: Importance of SALL4 in the development and prognosis of hepatocellular carcinoma.
abstract: OBJECTIVE
  To detect the expression of sal-like protein 4 (SALL4) and to explore its relationship with clinicopathological characteristics and prognosis of hepatocellular carcinoma (HCC).
  
  
  METHODS
  One hundred and twenty-six samples of HCC tissue, 44 of adjacent noncancerous cirrhotic tissue and 10 of liver hemangioma tissue, were obtained from patients who underwent hepatectomy for HCC at the Fourth Hospital of Hebei Medical University. None of the patients had received any form of treatment before the operation. After resection, all the tissues were fixed in 10% neutral formaldehyde and embedded in paraffin. Expression of SALL4 was detected by immunohistochemistry. Patients were followed up for postoperative survival until February 2014. The relationships between SALL4 expression level and clinicopathological data and prognosis of HCC were analyzed.
  
  
  RESULTS
  SALL4 expression was negative in the 10 samples of tissue from liver hemangioma, was weakly positive in the two samples from adjacent noncancerous cirrhotic tissue, and positive in 58 samples of HCC tissues. The differences were statistically significant (P < 0.05). Expression of SALL4 was higher in patients with higher α-fetoprotein (AFP) levels, portal vein tumor thrombus, and later clinical stage based on the Barcelona Clinic Liver Cancer classification (P < 0.05). Among patients with negative expression, weakly positive expression, positive expression, and strongly positive expression of SALL4, the median survival time was 39, 25, 23, and 9 mo, respectively (P < 0.001). When both AFP and SALL4 were detected, patients who were negative for both AFP and SALL4, SALL4-positive only, AFP-positive only, and positive for both AFP and SALL4, had a median survival time of 41, 38, 31, and 12 mo, respectively (P < 0.001).
  
  
  CONCLUSIONS
  Expression of SALL4 is relevant to the prognosis of HCC patients. Patients with higher expression levels of SALL4 and AFP have worse prognosis.
authors.affiliation: Fei Yin, Xin Han, Department of Gastroenterology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yin
authors.affiliation: Fei Yin, Xin Han, Department of Gastroenterology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Han
authors.affiliation: Fei Yin, Xin Han, Department of Gastroenterology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
authors.forename: Shu-Kun
authors.initials: SK
authors.lastname: Yao
authors.affiliation: Fei Yin, Xin Han, Department of Gastroenterology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Wang
authors.affiliation: Fei Yin, Xin Han, Department of Gastroenterology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
authors.forename: Hui-Chai
authors.initials: HC
authors.lastname: Yang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D002681:China; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D014157:Transcription Factors / Q000032:analysis*; D016896:Treatment Outcome; D015854:Up-Regulation; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; D014408:Biomarkers, Tumor; C472575:SALL4 protein, human; D014157:Transcription Factors; D000509:alpha-Fetoproteins
keywords: Hepatocellular carcinoma; Prognosis; Sal-like protein 4; Survival analysis; α-Fetoprotein