The expression status of ZIC2 is an independent prognostic marker of hepatocellular carcinoma

Abstract

Background: Zinc finger protein of cerebellum 2 (ZIC2) is a transcriptional activator or repressor that is important for the organogenesis of the central nervous system. Previous studies have reported that ZIC2 is widely upregulated in a variety of tumors. Methods: Oncomine database was used to evaluate the expression levels of ZIC2 in hepatocellular carcinoma (HCC) and normal liver tissues. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to validate the results from the database. Cox regression analysis and survival curves were performed to assess the survival effect of ZIC2 in HCC. Results: Increased expression of ZIC2 was detected in HCC tissues compared with normal liver tissues. In addition, patients with high ZIC2 levels had a poor prognosis. Multivariate analysis showed that clinical stage (T or M classification) and ZIC2 levels were independent prognostic factors for overall survival. Moreover, a subgroup analysis revealed that patients with moderate or poor grade tumors, T1–2 tumors, N0 tumors, early American Joint Committee on Cancer (AJCC) stage, and old age were more likely to present with overexpression of ZIC2. To conclude, ZIC2 is upregulated in HCC and associated with the histology and survival of HCC patients. Conclusions: The expression status of ZIC2 may serve as an independent prognostic marker of HCC. Keywords: Zinc finger protein of cerebellum 2 (ZIC2), Prognosis, Hepatocellular carcinoma (HCC), Liver, Biomarker