Abstract
PURPOSE: CCAAT/enhancer binding protein alpha (C/EBP alpha) is a transcription factor and a tumor suppressor. We aimed to assess its protein expression and prognostic value in human hepatocellular carcinoma (HCC). METHODS: We conducted a retrospective cohort study on 50 HCC patients and performed immunohistochemistry against C/EBP alpha on tumors and adjacent nontumor specimens. Relationships of C/EBP alpha expression with clinical parameters and patient survival were analyzed. RESULTS: C/EBP alpha expression was not influenced by chronic alcohol exposure, viral hepatitis, or cirrhosis, but was reduced in 60% of HCC. Reduction of C/EBP alpha was associated with advanced tumor stage (P = 0.001). Patients with markedly reduced C/EBP alpha expression had a significantly shorter survival with a hazard ratio of 5.45 (95% confidence interval, 1.93-15.40; P = 0.001). CONCLUSIONS: C/EBP alpha may be a potential prognostic marker or therapeutic target in HCC regardless of different etiology.