Growth arrest-specific homeobox is associated with poor survival in patients with hepatocellular carcinoma

Growth arrest-specific homeobox (GAX) codes for a transcription factor and plays a crucial role in many human cancers. Previous tumor studies have shown GAX may act as a suppressor of growth, invasion, and metastasis. However, little is known as to its role in hepatocellular carcinoma (HCC). Our aim was to investigate the expression of GAX in HCC and to make correlations with clinicopathologic features. Twenty-five pairs of HCC and adjacent non-tumor tissues, and six normal liver tissues were collected for GAX detection by Western blotting and real-time-PCR analysis. Immunohistochemistry was used to determine the expression of GAX in HCC and adjacent non-tumor tissues from 96 patients. Reduced expression of GAX was significantly associated with Edmondson stage, vascular invasion, and capsule invasion. Moreover, Kaplan-Meier curves showed that lower GAX expression was associated with shorter overall survival and disease-free survival in HCC patient. In conclusion, our study demonstrates for the first time that downregulated expression of GAX is an independent prognostic factor and is correlated with poor survival in HCC patients.