Jubo Zhang1 , Xiaodong Zhu1 , Pengyuan Zhuang1 , Zhaoyou Tang1 , Huichuan Sun1
1 Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai
Purpose : To investigate the prognostic values of the intratumoral and peritumoral macrophage colony-stimulating factors (M-CSF) and macrophages expression in hepatocellular carcinoma (HCC) patients after curative resection.
Patients and Methods : Density of M-CSF and macrophages (MΦ) was assessed by immunohistochemistry in tissue microarray containing paired tumor tissue and peritumoral liver tissue from 105 patients who received hepatectomy for histologically proved HCC. Prognostic effects of their densities and other clinicopathological factors were evaluated by Kaplan-Meier analysis and Cox regression, and their predictive effects were evaluated by ROC analysis.
Results : Neither intratumoral M-CSF nor MΦ density was associated with overall survival (OS) and disease-free survival (DFS). High peritumoral M-CSF and MΦ density, correlated with large tumor size, presence of intrahepatic metastasis and TNM stage, were independent prognostic factors for both poor OS ( P < 0.01) and DFS ( P < 0.01), and peritumoral M-CSF expression also affected incidence of early recurrence. In small HCC, only peritumoral M-CSF and HBeAg were correlated with both OS (P = 0.038, P = 0.008, respectively) and DFS (P = 0.001, P = 0.015, respectively). Combination of peritumoral M-CSF and MΦ had a better power to predict the patients’ death (AUC = 0.751, P < 0.001) and recurrence (AUC = 0.731, P < 0.001).
Conclusion : Peritumorally high M-CSF and MΦ expression was associated with poor survival of HCC after hepatectomy, and may be useful marker for selection of more individualized post-operative adjuvant therapy. Peritumoral tissue in the recurrence and metastasis of HCC deserve further study.