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Open Access Research

High intratumoral metastasis-associated in colon cancer-1 expression predicts poor outcomes of cryoablation therapy for advanced hepatocellular carcinoma

Yong-Ping Yang12*, Jian-Hui Qu1, Xiu-Juan Chang1, Yin-Ying Lu1, Wen-Lin Bai1, Zheng Dong1, Hong Wang1, Lin-Jing An1, Zhong-Xian Xu1, Chun-Ping Wang1, Zhen Zeng1 and Ke-Qin Hu3*

Author Affiliations

1 Center of Therapeutic Research for Liver Cancer, the 302nd Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China

2 Beijing Institute for Infectious Disease, Beijing, China

3 Division of Gastroenterology/Hepatology, University of California, 101 the City Dr., Building 56, Ste. 237, Irvine, CA 92868, USA

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Journal of Translational Medicine 2013, 11:41  doi:10.1186/1479-5876-11-41

Published: 15 February 2013

Abstract

Background

Cryoablation is one of the local therapies for hepatocellular carcinoma (HCC), but its safety and effect has not been studied in patients with Child class A or B and Barcelona Clinic Liver Cancer (BCLC) stage C HCC. Metastasis-associated in colon cancer-1 (MACC1) overexpression has been associated with poor prognosis of HCC, but its predictive value to post-cryoablation outcomes remains unknown in patients with BCLC stage C HCC.

Methods

This study assessed the safety and outcomes of cryoablation measured by time to progression (TTP) and overall survival (OS), and predictive value of MACC1 mRNA and protein overexpression in tumorous tissue to post-cryoablation outcomes in 120 advanced HCC patients with child-pugh class A or B by quantitative polymerase chain reaction and immunohistochemical staining. The potenial correlation of MACC1 and c-Met expression to tumor cell proliferation and apoptosis was also analyzed.

Results

The cryoablation in patients with advanced unresectable HCC resulted in a median TTP and OS of 5.5 (4.2- 6.7) months and 10.5 (9.0-12.0) months, respectively and no significant complications, comparable to the historical report for RFA therapy. The MACC1 mRNA and nuclear protein expression was significantly increased in tumorous tissues in these patients than that in normal liver tissue controls. Higher expression of MACC1 mRNA and nuclear protein in tumorous tissues in these patients was associated with shorter post cryoablation median TTP and OS than that with lower MACC1 expression.

Conclusions

Cryoablation is a safe and effective therapeutic option for patients with advanced HCC and Child-pugh class A or B cirrhosis; and a higher intratumoral expression of MACC1 or nuclear translocation predicts poor outcomes of cryotherapy in these patients.

Keywords:
Cryoablation; Metastasis-associated in colon cancer-1 (MACC1); Advanced hepatocellular carcinoma; Efficacy; Safety; Outcomes