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Research Article
Chih-Wen Lin
School of Medicine, College of Medicine, I-Shou University
Corresponding Author
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Background: Autophagy-related proteins may predict postresection overall survival (OS) and disease-free survival (DFS) in patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC).
Methods: We prospectively investigated how these proteins affect clinical prognosis in 40 patients who underwent hepatectomy for cHCC-CC from 2011 to 2019 at a Taiwanese hospital. Levels of autophagy-related proteins, namely LC3, Beclin-1, and p62, were immunohistochemically assessed in patient tumor and non-tumor tissues.
Results: We noted that LC3 expression was significantly correlated with mild clinicopathological characteristics, including macrovascular invasion, lymph node metastasis, American Joint Committee on Cancer and Barcelona Clinic Liver Cancer stages, recurrence, and mortality. Ten patient showed tumor recurrence, and 15 patients died. Postresection 5-year OS and DFS rates were 43.7% and 57.4%, respectively. Cox regression analysis showed that high intratumoral LC3 expression was significantly associated with improved OS [hazard ratio (HR; 95% confidence interval (CI)): (1.68–26.9), p = 0.007], but multiple tumors and microvascular invasion was significantly correlated with poor OS [HR (95% CI): 0.03 (0.01–0.34), p = 0.004, and 0.07 (0.01–0.46), p = 0.006, respectively]. Furthermore, high LC3 expression and cirrhosis had improved DFS [HR (95% CI): 51.3 (2.85–922), p = 0.008, and 17.9 (1.05–306), p = 0.046, respectively]. The 5-year OS and DFS rates were respectively 61.2% and 74.6% in high LC3 expression patients and 0% and 0% in those with low LC3 expression.
Conclusion: High LC3 expression in tumors is significantly associated with mild clinicopathological characteristics and favorable clinical prognosis in patients with cHCC-CC after resection.
Keywords
Combined hepatocellular carcinoma and cholangiocarcinoma, autophagy, LC3, prognosis, predictive factors
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1202123.png
Figure S1. LC3 expression in tumor tissues evaluated by immunohistochemical staining. Representive images according to the proportion of positive cells (A-D) and intensity of staining (E-H). (A) none, (B) <10 %, (C) 10-50 %, (D) >50 %; and staining (E) absent, (F) Weak; (G) moderate; (H) strong. (upper and lower panel, 400X).
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View the published article at BMC Cancer.
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Editorial decision: Major revision
On 28 May, 2021
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Received 08 May, 2021
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Editor invited
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A new preprint design is coming!
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See the published version of this preprint at BMC Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Chih-Wen Lin
School of Medicine, College of Medicine, I-Shou University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 1
Posted 01 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 28 May, 2021
Reviews received
Received 08 May, 2021
Reviewers agreed
On 28 Apr, 2021
Reviewers invited
Invitations sent on 08 Feb, 2021
Editor assigned
On 29 Jan, 2021
Editor invited
On 28 Jan, 2021
Submission checks complete
On 28 Jan, 2021
First submitted
On 22 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cancer Biology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
Background: Autophagy-related proteins may predict postresection overall survival (OS) and disease-free survival (DFS) in patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC).
Methods: We prospectively investigated how these proteins affect clinical prognosis in 40 patients who underwent hepatectomy for cHCC-CC from 2011 to 2019 at a Taiwanese hospital. Levels of autophagy-related proteins, namely LC3, Beclin-1, and p62, were immunohistochemically assessed in patient tumor and non-tumor tissues.
Results: We noted that LC3 expression was significantly correlated with mild clinicopathological characteristics, including macrovascular invasion, lymph node metastasis, American Joint Committee on Cancer and Barcelona Clinic Liver Cancer stages, recurrence, and mortality. Ten patient showed tumor recurrence, and 15 patients died. Postresection 5-year OS and DFS rates were 43.7% and 57.4%, respectively. Cox regression analysis showed that high intratumoral LC3 expression was significantly associated with improved OS [hazard ratio (HR; 95% confidence interval (CI)): (1.68–26.9), p = 0.007], but multiple tumors and microvascular invasion was significantly correlated with poor OS [HR (95% CI): 0.03 (0.01–0.34), p = 0.004, and 0.07 (0.01–0.46), p = 0.006, respectively]. Furthermore, high LC3 expression and cirrhosis had improved DFS [HR (95% CI): 51.3 (2.85–922), p = 0.008, and 17.9 (1.05–306), p = 0.046, respectively]. The 5-year OS and DFS rates were respectively 61.2% and 74.6% in high LC3 expression patients and 0% and 0% in those with low LC3 expression.
Conclusion: High LC3 expression in tumors is significantly associated with mild clinicopathological characteristics and favorable clinical prognosis in patients with cHCC-CC after resection.
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1202123.png
Figure S1. LC3 expression in tumor tissues evaluated by immunohistochemical staining. Representive images according to the proportion of positive cells (A-D) and intensity of staining (E-H). (A) none, (B) <10 %, (C) 10-50 %, (D) >50 %; and staining (E) absent, (F) Weak; (G) moderate; (H) strong. (upper and lower panel, 400X).
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