Influence of Forkhead box Q1 expression on therapeutic effect of transarterial chemoembolization after hepatocellular carcinoma surgery

Objective To investigate the expression of Forkhead box Q1( FOXQ1) in the tissue of hepatocellular carcinoma( HCC),its influence on the prognosis of surgical resection combined with transarterial chemoembolization( TACE),and the value of FOXQ1 in evaluating the treatment outcome of HCC. Methods A total of 120 HCC patients who were admitted to The Affiliated Tumor Hospital of Nantong University from January 2004 to December 2007 were enrolled. Immunohistochemistry was used to measure the expression of FOXQ1 in HCC tissue,which was compared with patients' clinical features. The chi- square test was used for comparison of categorical data between groups,the Kaplan- Meier curve and log- rank test were used to analyze patients' disease- free survival( DFS) rates after surgery,and the Cox proportional hazards regression model was used for univariate and multivariate regression analyses. Results The results of immunohistochemistry showed that FOXQ1 had a dark- brown color in HCC tissue and was mainly expressed in tumor cytoplasm and nucleus. The univariate regression analysis showed that patients' DFS was affected by TNM stage( HR = 0. 347,95% CI: 0. 210- 0. 573,P < 0. 001),the number of tumors in the liver( HR = 0. 294,95% CI: 0. 176- 0. 490,P < 0. 001),HBV infection( HR = 0. 395,95% CI: 0. 222-0. 704,P = 0. 002),alpha- fetoprotein expression( HR = 0. 348,95% CI: 0. 207- 0. 586,P < 0. 001),presence or absence of liver cirrhosis( HR = 0. 414,95% CI: 0. 244- 0. 702,P = 0. 001),and high FOXQ1 expression level( HR = 1. 968,95% CI: 1. 171- 3. 308,P = 0. 011). Multivariate regression analysis showed that the patents' DFS was associated with TNM stage( HR = 0. 466,95% CI: 0. 248-0. 874,P = 0. 017),the number of tumors in the liver( HR = 0. 427,95% CI: 0. 216- 0. 844,P = 0. 014),and high FOXQ1 expression level( HR = 2. 896,95% CI: 1. 628- 5. 152,P < 0. 001). The patients with a high FOXQ1 expression level had a shorter DFS than those with a low FOXQ1 expression level( 18 months vs 26 months,χ2= 5. 006,P = 0. 025). Conclusion FOXQ1 can be used as a biomarker to evaluate the prognosis of HCC patients and the treatment outcome of HCC.