Decreased nuclear expression of FTO in human primary hepatocellular carcinoma is associated with poor prognosis

Fat mass and obesity-associated protein (FTO) has been well known for a pivotal role in regulation of fat mass, adipogenesis and body weight. In recent years, increasing studies revealed a strong association between FTO and various types of cancer. Its role in human hepatocellular carcinoma, however, remains unclear. We aimed at investigating the expression pattern and clinical significance of FTO in hepatocellular carcinoma. We found that FTO mRNA levels were significantly lower in hepatocellular carcinoma tissues. Immunohistochemical analysis showed the expression of FTO was reduced in the nuclei in hepatocellular carcinoma, and was associated with AFP level (P < 0.001), tumor size (P < 0.001), metastasis (P = 0.025) and vascular invasion (P < 0.001). Patients with decreased FTO expression had a shorter overall and tumor-free survival time (P = 0.004 and P = 0.006) than those with normal FTO expression. Cox's proportional hazard regression model revealed that reduced expression of FTO was a risk factor associated with the prognosis of HCC patients (P = 0.022). These results indicated that decreased FTO expression is correlated with clinicopathological factors, implying that FTO could be a vital predictor of poor outcome in HCC patients and serves as a novel biomarker for HCC.