Evidence map›Paper›PMID 31094090›Full record

ArticleCancer medicine2019

Axl and autophagy LC3 expression in tumors is strongly associated with clinical prognosis of hepatocellular carcinoma patients after curative resection.

Chia-Chang Hsu, Pei-Min Hsieh, Yaw-Sen Chen, Gin-Ho Lo, Hung-Yu Lin, Chia-Yen Dai, Jee-Fu Huang, Wan-Long Chuang, Yao-Li Chen, Ming-Lung Yu and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 26 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Chia-Chang HsuSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Pei-Min HsiehSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Yaw-Sen ChenSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Gin-Ho LoDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
Hung-Yu LinSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Chia-Yen DaiGraduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Jee-Fu HuangHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Wan-Long ChuangHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yao-Li ChenDivision of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Ming-Lung YuCenter for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chih-Wen LinSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.ORCID 0000-0003-2344-5056
Kaohsiung Medical University · TWE-Da Hospital · TWChanghua Christian Hospital · TWNational Sun Yat-sen University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of Axl and LC3 as predictors of tumor recurrence and overall survival (OS) after hepatocellular carcinoma (HCC) resection remains unclear.

methodsWe retrospectively included 535 HCC patients who underwent hepatectomy from 2010 to 2014 in this study. Axl and the autophagy-related marker LC3 were immunohistochemically assessed in tumors.

resultsAxl expression was significantly associated with advanced clinicopathological features, including cirrhosis, microvascular invasion, macrovascular invasion, tumor size, BCLC stage, recurrence, and mortality. HCC recurrence occurred in 245 patients, and 219 patients died. The 5-year cumulative incidences of HCC recurrence and OS rate after HCC resection were 53.3% and 58.8%, respectively. In the Cox proportional analyses, high Axl expression and high LC3 expression were significantly associated with HCC recurrence (hazard ratio [HR]: 3.85, 95% confidence interval [CI]: 2.95-5.02, P < 0.001; and HR: 0.38, 95% CI: 0.26-0.55, P < 0.001, respectively). In addition, HCC recurrence (HR: 2.87, 95% CI: 2.01-4.01, P < 0.0001), microvascular invasion (HR: 1.85, 95% CI: 1.08-3.19, P = 0.026), hepatitis B virus-related HCC (HR: 1.77, 95% CI: 1. 21-2.56, P = 0.003), high Axl expression (HR: 1.66, 95% CI: 1.41-1.97, P < 0.0001), antiviral therapy (HR: 0.54, CI: 0.38-0.76, P < 0.001) and LC3 expression (HR: 0.41, 95% CI: 0.28-0.58, P < 0.001) were significantly associated with mortality. Furthermore, patients with a combination of high Axl and low LC3 expression had the highest risk of HCC recurrence (HR: 6.53, 95% CI: 4.11-10.4, P < 0.001) and mortality (HR: 6.66, 95% CI: 4.07-10.9, P < 0.001). In patients with high Axl, low LC3, and combined high Axl and low LC3 expression, the 5-year cumulative incidences of HCC recurrence and OS rate were 77.9%, 73.3%, and 90.0% and 28.8%, 26.7%, and 16.8%, respectively.

conclusionHigh Axl expression in tumors is associated with aggressive tumor behavior and worse clinical outcomes. Furthermore, the combination of high Axl and low LC3 expression significantly predicts poorer prognosis for HCC patients who underwent hepatectomy.

Indexed as

Gene Expression Regulation, NeoplasticAdultAgedAutophagyAxl Receptor Tyrosine KinaseCarcinoma, HepatocellularFemaleHepatectomyHumansLiver NeoplasmsMaleMicrotubule-Associated ProteinsMiddle AgedNeoplasm StagingPrognosisProportional Hazards ModelsAXL protein, humanAxl Receptor Tyrosine KinaseMAP1LC3A protein, humanMicrotubule-Associated ProteinsProto-Oncogene ProteinsReceptor Protein-Tyrosine Kinasesautophagy LC3Axlhepatocellular carcinomaoverall survivalpredictorsrecurrence

Identifiers

PMID31094090
PMCPMC6601576
OpenAlexW2944889302

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.