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Linkage of elevated ets-2 expression to hepatocarcinogenesis.

BACKGROUND
Previous studies have shown that ets-2, a transcription factor, is linked to carcinoma progression. In the present study, we investigated the expression and clinical significance of ets-2 in hepatocellular carcinoma (HCC) and malignant transformation of the liver.


MATERIALS AND METHODS
The expression of ets-2 was immunohistochemically investigated with 91 HCC, 46 noncancerous lesions, 8 atypical adenomatous hyperplasias and 14 normal liver controls.


RESULTS
The ets-2 labeling index (LI) in normal liver was significantly lower than in noncancerous lesion (p<0.0001). The LI in atypical adenomatous hyperplasia tended to be higher than in noncancerous lesion (p=.0779). In HCC, the LI was significantly lower (p<0.0001) than that in noncancerous lesion and atypical adenomatous hyperplasia. In HCC, the ets-2 expression level was significantly lower in cases with advanced stage (p=0.0085), large size (p=0.0441), high proliferating activity (p<0.0001), poor differentiation (p=0.0005), the presence of portal invasion (p=0.0009) and intrahepatic metastasis (p=0.0236) and shorter disease-free survival (p=0.0372).


CONCLUSION
These findings suggest that ets-2 plays an important role predominantly in malignant transformation of the liver.