studies

424A AASLD ABSTRACTS HEPATOLOGY, October, 2015
425
Staging Hepatocellular Carcinoma in Non-Cirrhotic
Patients
Philippe Kolly 1,2 , Helen Reeves 3,4 , Marina Knöpfli 2 , Jean-Francois
Dufour 1,2 ; 1 Hepatology, Department of Clinical Research, University
of Bern, Bern, Switzerland; 2 University Clinic for Visceral
Surgery and Medicine, Inselspital Bern, Bern, Switzerland; 3 The
Northern Institute for Cancer Research, Newcastle University,
Newcastle-upon-Tyne, United Kingdom; 4 The Liver Unit, Freeman
Hospital, Newcastle-upon-Tyne, United Kingdom
To design a staging system for HCC in non-cirrhotic patients,
we used a pooled set of 864 patients combining 2 prospective
European cohorts. Among them, 221 had a non-cirrhotic
liver. Cirrhosis was excluded based on clinical presentation
and imaging. The staging and treatment algorithm was constructed
by using Cox regression, regression tree analysis and
evidenced based literature. We created the Non-Cirrhotic Liver
Cancer (NCLC) staging system. Based on the ECOG PS, tumor
burden (size and number of nodules), presence of vascular
invasion and metastasis, this staging system proposes 4 stages.
Each stage is associated with treatment options, separated in
first and second intention treatments (Fig.). We assessed the
discriminatory power of the staging system by Log-Rank (p
< 0.001). The prognostic ability of the staging system was
assessed with Harrell’s concordance index (0.729). HCC
developing in non-cirrhotic patients represents 10-40% of
HCC. With the growing incidence of NAFLD-associated HCC,
this proportion will rise. The BCLC staging system, which has
been endorsed by AASLD and EASL, has not been developed
for non-cirrhotic patients. The statistical analysis revealed that
the performance status and the tumor burden are discriminating
parameters to classify non-cirrhotic patients with HCC in 4
different stages with different prognostics and treatment allocation.
A staging system for HCC developing in non-cirrhotic
patients has become essential. The NCLC has been designed
specifically for this purpose and will need to be further developed.
Figure legend: NCLC staging and treatment algorithm.
This algorithm stages HCC in non-cirrhotic patients according
to ECOG PS, tumor burden and the existence of vascular invasion
or metastasis. It suggests 4 stages and the corresponding
treatments, separated in first and second intention.
426
Clinical significance of microRNA-31 expression in
human hepatocellular carcinoma
Keun Hur 1 , Se Young Jang 2 , Soo Young Park 2 , Gyeonghwa Kim 1 ,
Yong-Hun Choi 1 , Yu Rim Lee 2 , Su Hyun Lee 2 , Sun Kyung Jang 2 ,
Won Young Tak 2 , Young Oh Kweon 2 ; 1 Department of Biochemistry
and Cell Biology, Kyungpook National University School of
Medicine, Daegu, Korea (the Republic of); 2 Department of Internal
Medicine, Kyungpook National University Hospital, Daegu, Korea
(the Republic of)
Background & aims Hepatocellular carcinoma (HCC) is one
of the most leading cause of cancer-related death worldwide.
It is therefore important to understand the mechanistic roles of
biomolecules involved in HCC development. MicroRNAs (miR-
NAs) are small noncoding RNAs that act as an important regulator
of gene expression in various tumor development as well
as metabolic diseases. This study aim to investigate the role
of miR-31 in HCC and non-alcoholic steatohepatitis (NASH).
Methods We analyzed clinical specimens from HCC, matched
normal liver, and NASH tissues. MicroRNAs expression levels
were evaluated by quantitative real-time PCR (qRT-PCR) and
miR-31 expression was normalized relative to RNU6B expression.
In addition, we determined the clinical significance of
the miR-31 expression in matching tissue and serum samples
from HCC patients. Results MiR-31 expression was significantly
upregulated in HCC and NASH tissues compared with normal
liver tissues (p=0.0015). In HCC patients, lower level of
miR-31 (p