Background: The biological significance of the nuclear enzyme DNA topoisomerase II in hepatocellular carcinoma (HCC) remains unclear.
Materials and methods: Using immunohistochemical staining methods, we examined the clinical significance of topo IIalpha (8D2) in surgically resected HCC, comparing the expression of both Ki-67 and p53, as well as various clinicopathological factors and prognosis.
Results: The 70 HCC samples showed a positive, but heterogeneous pattern. The mean topo IIalpha labeling index (LI) was 14.1 +/- 15.1%, and ranged from 0.2 to 55.6, and the median topo IIalpha LI was 9.9%. The mean value of the topo IIalpha LI in p53-positive HCC cases (25.6 +/- 17.4) was significantly higher than that in p53-negative cases (10.3 +/- 12.3). HCC patients with lower topo IIalpha LI had significantly longer disease-free survival and exhibited a longer cumulative survival period than did those with higher topo lIalpha LI.
Conclusion: Topo IIalpha over-expression appears to be linked with a potentially aggressive tumor phenotype and may indicate tumor recurrence and cancer-related death in HCC.