Prognostic significance of combined PCPE-1 and α-fetoprotein for hepatocellular carcinoma

• Published in: Translational oncology 2025-01, Vol.51, p.102185, Article 102185
• Main Authors: Zhang, Ruhua, Chen, Wanqi, Peng, Xuelan, Zhang, Zhiguang, Yang, Shangjiu, Zhong, Li
• Format: Article
• Language: English
• Subjects: AFP; Hepatocellular carcinoma; Original Research; PCPE-1; Prognosis; Survival
• ISSN: 1936-5233; 1936-5233
• DOI: 10.1016/j.tranon.2024.102185

•This is the first evidence that high PCPE-1 expression is correlated with poor prognosis in HCC.•PCPE-1 emerges as an independent prognostic marker for HCC.•The prognostic model developed in this study, combining PCPE-1 and AFP, may have potential implications for evaluating the prognosis of hepatocellular carcinoma patients and guiding precise treatment for patients with HCC in the future. Procollagen C-proteinase enhancer 1 (PCPE-1) is associated with liver fibrosis, a major risk factor of hepatocellular carcinoma (HCC). However, its role in HCC remains unclear. The mRNA and protein expression levels of PCPE-1 were analyzed using publicly available datasets of HCC tissues and matched normal tissues. Western blotting was performed to determine PCPE-1 levels in 7 paired HCC tumor and normal tissues. Immunohistochemistry was used to detect PCPE-1 levels in 155 HCC patients. The ROC curve was employed to determine the optimal cutoff value of PCPE-1. Univariate and multivariate analyses identified independent risk factors associated with overall survival (OS) of HCC patients. Kaplan-Meier analysis assessed the relationship between PCPE-1 expression and OS, and a prognostic model was constructed. PCPE-1 protein was upregulated in HCC tissues compared to normal tissues and positively correlated with the expression of several procollagens. 78 out of 155 HCC patients exhibited elevated PCPE-1 expression with cytoplasmic staining. High PCPE-1 expression significantly correlated with tumor necrosis (P = 0.045), poorer histologic grade (G3-G4, P = 0.008), and higher α-fetoprotein (AFP) level (>20 ng/ml, P = 0.043). Both univariate and multivariate analyses showed a significant association between elevated PCPE-1 and poorer overall survival (P < 0.001 in both analyses). Remarkably, combined prognostic model with PCPE-1 and AFP effectively stratified the risk for OS in HCC. Our results demonstrate for the first time that PCPE-1 serves as an independent prognostic marker for HCC, and the combined prognostic model involving PCPE-1 and AFP emerges as a valuable tool for predicting patient outcomes.