title: Positive immunostaining of Sal-like protein 4 is associated with poor patient survival outcome in the large and undifferentiated Korean hepatocellular carcinoma.
abstract: OBJECTIVE
  Previous studies have shown the role of Sal-like protein 4 (SALL4) as a biomarker in hepatocellular carcinoma (HCC), and some studies have shown the relationship between SALL4 and prognosis. Given the debates in study groups differences in terms of etiologic causes between Western and Asian HCC and detection methods, we attempted to verify the features of SALL4 immunoreactivity and its clinical correlation in Korean HCC patients.
  
  
  METHODS
  Immunohistochemical staining of SALL4 of tissue microarrays (TMAs) consisting of 213 surgically resected HCC patients' tissue were scored in a semiquantitative scoring system with immunoreactive score and the results analyzed with clinical outcome, in addition to general demographics and clinical characteristics.
  
  
  RESULTS
  SALL4 immunoreactivity was expressed in 50 cases. Relevance between SALL4 and α-FP correlated significantly (P = 0.002). Also, the SALL4-positive patients had considerably higher tumor grade (P < 0.001). The survival analysis showed negative correlation with SALL4 immunoreactivity in all HCC patient groups, but SALL4 immunoreactivity in T3 and T4 HCC correlated with poor prognosis.
  
  
  CONCLUSIONS
  Here, we found that positive immunostaining of SALL4 is correlated with poor patient survival outcome in large and undifferentiated Korean HCC. SALL4 expression showed close relationship with clinical outcomes of HCCs in Korean patients.
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Yun Kyung
authors.initials: YK
authors.lastname: Jung
authors.affiliation: Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kiseok
authors.initials: K
authors.lastname: Jang
authors.affiliation: Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Seung Sam
authors.initials: SS
authors.lastname: Paik
authors.affiliation: Department of Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Han Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kyeong Geun
authors.initials: KG
authors.lastname: Lee
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hwon Kyum
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dongho
authors.initials: D
authors.lastname: Choi
keywords: Hepatocellular carcinoma; Immunohistochemistry; Microarray analysis; Prognosis; SALL4 protein