Introduction : Heme oxygenase-1 (HO-1) is an important catalytic enzyme in heme degradation and is increased in stressful conditions. It plays a major role in anti-oxidative and anti-apoptotic processes and is associated with tumor growth and metastasis. This study aimed to evaluate the degree of HO-1 expressions in surgical specimens of hepatocellular carcinoma (HCC) and the correlation between HO-1 expression and patient prognosis

Methods : Formalin-fixed, paraffin-embedded tissue samples of hepatocellular carcinoma (n=96) were eligible and the expression of HO-1 was evaluated by immunohistochemical staining. We reviewed clinical features of patients and evaluated the prognostic role of HO-1 in patient survival and recurrence.

Results : Positive HO-1 expression was identified in 43 cases (44.8%) and was frequently found in patients with advanced histology (Edmondson-Steiner grade 2, 3, 4), α-fetoprotein (AFP) level of more than 200IU/ml, the presence of lymphovascular invasion, and capsular invasion (p < 0.05). In a univariate analysis, overall survival, and disease-free survival of HO-1 positive HCC were not statistically different from those of HO-1 negative HCC. Also, HO-1 expression was not associated with patient survival and recurrence in a multivariate analysis. In a subgroup analysis of those patients without preoperative transarterial chemo embolization (n=61), HO-1 was not also associated with tumor recurrence (p=0.681).

Conclusions : The clinical implication of HO-1 activity is controversial in various malignancies. However, HO-1 expression did not seem to influence the prognosis of HCC patients.