Circular RNA Hsa_circ_0062403 Acts as a Potential Prognostic Biomarker for Early Recurrence of Hepatocellular Carcinoma

Purpose: Circular RNAs (circRNAs) have been shown to have critical regulatory roles in hepatocellular carcinoma (HCC). This study aims to investigate the predictive value of circLZTR1 for early recurrence of HCC. Patients and Methods: In this study, circLZTR1 (a circRNA derived from the LZTR1, hsa_circ_0062403) was identified and validated in the HCC cohort. Univariate analyses and multivariate Cox regression were conducted to analyze the functional role of hsa_circ_0062403 in the postoperative early recurrence of HCC patients. Receiver operating characteristic curve (ROC) analysis was performed to assess the predictive performance of hsa_circ_0062403 for early recurrence. Results: 91 patients with HCC after surgery were included. circLZTR1 was downregulated in early recurrence HCC patients and predicted poor recurrence-free survival (P=0.029). In addition, a significant downregulation of circLZTR1 was observed in HCC from patients with MVI or PVTT. Multivariate Cox regression analysis indicated that lower circLZTR1 (> 0.25 vs < 0.1; HR = 0.142, 95% CI: 0.042– 0.482, P = 0.002), higher AFP (> 400 vs < 20; HR = 7.880, 95% CI: 2.499– 24.844, P < 0.001), higher INR (HR = 4.203, 95% CI: 1.133– 15.588, P = 0.032), multiple tumors (HR = 3.795, 95% CI: 1.541– 9.346, P = 0.004), PVTT positive (HR = 3.438, 95% CI: 1.050– 11.258, P = 0.041), and larger tumor diameter (HR = 1.306, 95% CI: 1.101– 1.550, P = 0.002) served as independent risk factor for early recurrence of HCC. ROC analysis indicated that the Cox model demonstrated higher sensitivity and specificity than the clinical model and single circLZTR1 in prediction for early recurrence of HCC patients (AUC = 0.767, 95% CI: 0.666– 0.868, P < 0.001). Conclusion: The downregulation of circLZTR1 is closely associated with the acquisition of invasive phenotypes, vascular invasion, and subsequent early recurrence of HCC patients, suggesting that circLZTR1 may serve as a novel prognostic biomarker for predicting early recurrence in patients with HCC.