This study was designed to investigate the associations between TERT overexpression and the clinicopathologic factors of hepatocellular( ). A total of 291 with were enrolled. The site of first recurrence (anywhere in the liver) was classified as intrahepatic recurrence (IHR). Recurrence was then sub classified as either early or late IHR according to whether it was discovered within 2 years of resection, or after, respectively. TERT overexpression was not significantly correlated with previously recognized prognostic factors. During follow-up, early IHR occurred in 126 (63.6%) , while late IHR was detected in 59 among 145 who remained free of recurrence for ≥ 2 years after . Multivariate analysis showed late IHR was significantly correlated with TERT overexpression (P < 0.001, hazard ratio [HR] 2.67, 95% confidence interval [CI] 1.51–4.72). Intrahepatic metastasis (P < 0.001, HR 4.48, 95% CI 2.62–7.65) and TERT overexpression (P < 0.001, HR 1.77, 95% CI 1.28–2.45) were significant prognostic factors for IHR-free survival in both univariate and multivariate analyses. TERT overexpression was the only significant prognostic factor for late IHR in treated with curative resection. And, the statistical significance of TERT overexpression on late IHR was limited to HBsAg-positive patients.
1.( ) remains one of the most challenging health problems worldwide despite the hepatitis B virus (HBV) vaccine, surveillance in high-risk , potent antiviral agents, and imaging and treatment modalities. Currently, is the fifth most common , and the second leading cause of cancer-related death worldwide
The Barcelona Clinic 2. One study found that the local control rate of was comparable between resection and RFA3. resection is generally preferred, if possible, however, because of the difference in overall recurrence after compared to that after other treatment modalities4,5,6. Unfortunately, recurrence is still detected in approximately 50% of after surgical resection7. There is no standardized adjuvant treatment modality after HCC surgical resection. Therefore, it is very important to identify reliable biomarkers of recurrence, as well as the most probable sites of recurrence, in order to develop customized management plans.(BCLC) system is the most widely used staging and treatment guideline. According to BCLC, the curative treatments for include liver transplantation (LT), resection, and local ablative therapy, including radiofrequency ablation (RFA)
Telomerase reverse transcriptase (TERT) is a core catalytic component of telomerase that plays a crucial role in maintaining telomere length8. In most somatic cells, TERT expression is suppressed. In contrast, TERT is actively expressed in self-renewing cells, such as stem cells9. Overexpression of TERT and telomere dysfunction is frequently detected in a variety of human specimens, including 10, 11, melanoma12, and 13. This TERT overexpression is detected in up to 90% of cells, compared to in <20% of normal cells14. Evidence has suggested that TERT overexpression in is associated with poor clinical outcomes; however, this hypothesis was based on a small population, without consideration of other clinicopathologic factors that might affect clinical outcomes15. Therefore, it is essential to more precisely evaluate the role of TERT overexpression in , as well as that of other clinicopathologic factors in homogenously-treated .
We investigated the associations between TERT overexpression and the clinicopathologic factors ofin Korean mainly caused by HBV . We also studied the clinical significance of TERT overexpression with regard to recurrence and survival duration