Expression and possible role of ets-1 in hepatocellular carcinoma

Recent studies on the transcriptional factor ets-1 and carcinoma have shown that ets-1 is linked to carcinoma progression, including tumor invasion an d metastasis. We studied the clinical significance of ets-1 in human hepato cellular carcinoma (HCC) by using immunohistochemical staining methods. In 99 HCC cases, the levels of ets-1 expression were analyzed in comparison wi th various clinicopathologic parameters, such as TNM stage, intrahepatic me tastasis, histologic differentiation, and prognosis. Expression of ets-1 wa s scarcely detected in normal liver but markedly enhanced in noncancerous l esions adjacent to HCC lesions. In HCC lesions, ets-1 expression was observ ed with high incidence, although the average labeling index (LI) was lower than in noncancerous lesions. However, unexpectedly, the average LI in HCC was lower in cases of high TNM stage, poor differentiation, portal invasion , intrahepatic metastasis, large turner size, and high Ki-67 LI. Furthermor e, cases with high ets-1 expression showed better outcomes for disease-free survival than those with low ets-1 expression by univariate and multivaria te analyses. These findings strongly suggest that, unlike in other neoplasm s, ets-1 has a crucial role in hepatocarcinogenesis and HCC progression, es pecially during their early phases.