Hepatocellular Carcinoma: Overexpression of Homeoprotein Six1 as a Marker for Predicting Survival

Hepatocellular carcinoma (HCC) which occurs in 80% of all primary liver is the fifth most common cancer and the third most common cause of death from cancer in the world (Parkin et al., 2001; Befeler and Di Bisceglie, 2002). The incident rate of HCC, which is highest in Asia and Africa, is increasing in Western countries. In the United States, 19,160 new cancers of the liver and intrahepatic bile duct were estimated in 2007, with an estimated 16,780 deaths (Jemal et al., 2007). Chronic hepatitis B infection is the most common cause of HCC in China and Southeast Asia (Muller, 2006), while hepatitis C infection is of high importance in Europe, Japan and North America (Bosch et al., 1999). Other common risk factors for hepatocar-cinogenesis include alcohol, aflatoxin ²1, cirrhosis, ±-1-antitrypsin deficiency and hereditary hemochromatosis. Currently, there is no standard treatment for advanced HCC. Surgical treatments, including hepa-tectomy and liver transplantation, are major curative options for HCC. However, long-term survival rate remains unsatisfactory due to tumor recurrence and metastasis (Poon and Fan, 2004; Lo and Fan, 2004; Llovet et al., 2005). For better stratification and management of HCC patients, identification of potential markers for accurate prognosis of HCC patients in terms of malignancy and survival rate is indispensable.