Increased expression of transforming growth factor-α in a patient with recurrent hepatocellular carcinoma following partial hepatectomy

A 45-year-old woman with chronic hepatitis B underwent partial hepatectomy for hepatocellular carcinoma (HCC). However, the HCC recurred 2 months after surgery and rapid progression of the disease resulted in her death. Immunohistochemistry showed that transforming growth factor-alpha (TGF alpha) was barely expressed in the liver specimens obtained at hepatic resection, whereas autopsy specimens were strongly stained with anti-TGF alpha antibody in the cytoplasm of both non-tumourous and tumourous liver cells. A higher level of Ki67 expression, a proliferating marker, was observed in the recurrent HCC, similar to that of TGF alpha. Thus, we speculate that the partial hepatectomy increased the level of TGF alpha leading to recurrence and progression of HCC through an autocrine/paracrine mechanism.