title: The diagnostic and prognostic value of SALL4 in hepatoblastoma.
abstract: OBJECTIVE
  To investigate the expression of spalt-like transcription factor 4 (SALL4), a regulator of embryonal development, in three epithelial components of hepatoblastoma (HB) and the relationship between SALL4 expression levels and patients' clinicopathological features.
  
  
  RESULTS
  A total of 115 specimens from 79 patients with HB were selected for immunostaining of SALL4. Nuclear staining was semi-quantified using the immunoreactive score (IS; range: 0-12). SALL4 expression was seen in all embryonal components (mean IS = 8.58) and in 41% of fetal components (mean IS = 0.78). No SALL4 expression was seen in either small cell undifferentiated or mesenchymal components of HB. Neither chemotherapy nor metastasis altered SALL4 expression significantly. High SALL4 expression levels were associated significantly with decreased overall survival (OS) (P = 0.004), event-free survival (EFS) (P = 0.003) and the presence of metastasis (P = 0.049) on univariate analysis. Multivariate analysis identified SALL4 as an independent prognostic predictor for OS (P = 0.029).
  
  
  CONCLUSIONS
  SALL4 is useful for subtyping HB, and high SALL4 expression is associated with decreased survival in HB.
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. szhou@chla.usc.edu.|Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. szhou@chla.usc.edu.
authors.forename: Shengmei
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Texas Children's Cancer Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Venkatramani
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Gomulia
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.|Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Shillingford
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.|Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Wang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D018197:Hepatoblastoma / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D014157:Transcription Factors / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C472575:SALL4 protein, human; D014157:Transcription Factors
keywords: SALL4; hepatoblastoma; immunohistochemistry; malignant pediatric liver tumour