Overexpression of LBH is associated with poor prognosis in human hepatocellular carcinoma

Purpose: Limb-bud and heart (LBH) levels are correlated with adverse survival in several malignancies; however, their significance in hepatocellular carcinoma (HCC) remains unclear. The objective of this study was to determine the association between LBH status and clinical outcomes. Methods: We selected 226 patients with HCC who were treated surgically between 2003 and 2010 at a single academic center. Immunohistochemistry (IHC) was used to detect the protein expression of LBH in HCC samples. Receiver operating characteristic (ROC) curve analysis, Spearman’s rank correlation, Kaplan–Meier plots, and the Cox proportional hazards regression model were used to analyze the data. Results: A high expression of LBH was detected in 20 (8.8%) of 226 HCC samples. Correlation analysis demonstrated that LBH in HCC was significantly correlated with aspartate amino­transferase (AST)/alanine aminotransferase (ALT) levels and clinical stages ( P <0.05). In the Kaplan–Meier analysis, the mean survival time of patients with low levels of LBH was longer than that for those with high levels of LBH ( P <0.05). The 3-year overall survival rate was 20% for patients with HCC and high levels of LBH versus 67% for patients with HCC and low levels of LBH. In the multivariate analysis, AST/ALT level, clinical stage, tumor relapse, and the level of LBH were the independent prognostic factors for overall survival ( P <0.05). Conclusion: Overexpression of LBH might contribute to the development and progression of HCC. LBH could be a novel prognostic marker for HCC.