Cellular Prion Protein Is Closely Associated with Early Recurrence and Poor Survival in Patients with Hepatocellular Carcinoma

The cellular prion protein (PrP^C) is known to play a role in cancer proliferation and metastasis. However, the role of PrP^C expression in hepatocellular carcinoma (HCC) is unknown. This study investigated whether overexpression of PrP^C affects recurrence after surgical resection and survival in HCC. A total of 110 HCC patients who underwent hepatic resection were included. They were followed up for a median of 42 months (range 1-213 months) after hepatectomy. The relationships between PrP^C expression and the HCC histologic features, recurrence of HCC following surgical resection, and survival of the patients were examined. Seventy-one cases (64.5%) of HCC demonstrated higher expression of PrP^C. The expression of PrP^C was only correlated with diabetes mellitus. There was no association between PrP^C expression and age, sex, hypertension, hepatitis B virus positivity, alcohol consumption, Child-Pugh class, major portal vein invasion, serum alpha-fetoprotein, and HCC size or number. The 1-year recurrence rates in patients with higher PrP^C expression were higher than those with lower PrP^C expression. The cumulative survival rates of patients with higher PrP^C expression were significantly shorter than those of patients with lower PrP^C expression. In conclusion, PrP^C expression is closely associated with early recurrence and poor survival of HCC patients following surgical resection.