Inactivation of hippo pathway is significantly associated with poor prognosis in hepatocellular carcinoma

Bo Hwa Sohn, Jae Jun Shim, Sang Bae Kim, Kyu Yun Jang, Soo Mi Kim, Ji Hoon Kim, Jun Eul Hwang, Hee Jin Jang, Hyun Sung Lee, Sang Cheol Kim, Woojin Jeong, Sung Soo Kim, Eun Sung Park, Jeonghoon Heo, Yoon Jun Kim, Dae Ghon Kim, Sun Hee Leem, Ahmed Kaseb, Manal M. Hassan, Minse ChaIn Sun Chu, Randy L. Johnson, Yun Yong Park, Ju Seog Lee

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87 Scopus citations


Purpose: The Hippo pathway is a tumor suppressor in the liver. However, the clinical significance of Hippo pathway inactivation in HCC is not clearly defined. We analyzed genomic data from human and mouse tissues to determine clinical relevance of Hippo pathway inactivation in HCC. Experimental Design: We analyzed gene expression data from Mst1/2-/- and Sav1-/- mice and identified a 610-gene expression signature reflecting Hippo pathway inactivation in the liver [silence of Hippo (SOH) signature]. By integrating gene expression data from mouse models with those from human HCC tissues, we developed a prediction model that could identify HCC patients with an inactivated Hippo pathway and used it to test its significance in HCC patients, via univariate and multivariate Cox analyses. Results: HCC patients (National Cancer Institute cohort, n = 113) with the SOH signature had a significantly poorer prognosis than those without the SOH signature [P < 0.001 for overall survival (OS)]. The significant association of the signature with poor prognosis was further validated in the Korean (n = 100, P = 0.006 for OS) and Fudan University cohorts (n = 242, P = 0.001 for OS). On multivariate analysis, the signature was an independent predictor of recurrence-free survival (HR, 1.6; 95% confidence interval, 1.12-2.28: P = 0.008). We also demonstrated significant concordance between the SOH HCC subtype and the hepatic stem cell HCC subtype that had been identified in a previous study (P < 0.001). Conclusions: Inactivation of the Hippo pathway in HCC is significantly associated with poor prognosis. Clin Cancer Res; 22(5); 1256-64.

Original languageEnglish
Pages (from-to)1256-1264
Number of pages9
JournalClinical Cancer Research
Issue number5
StatePublished - 1 Mar 2016

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Publisher Copyright:
© 2015 American Association for Cancer Research.


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