The Expression and Prognostic Role of Hepatoma-Derived Growth Factor in Colorectal Stromal Tumors

PURPOSE: This study investigated the expression and prognostic role of hepatoma-derived growth factor (HDGF) in colorectal stromal tumor. METHODS: Fifty-two surgically resected colorectal stromal tumors were collected from 1986 to 2006. Immunohistochemical studies were performed with antibodies of HDGF, proliferating cell nuclear antigen (PCNA) and Ki-67. RESULTS: Sixteen patients (30.7 percent) had positive Ki-67 immunostaining. Immunoreactivity to PCNA ranged from 10 to 93 percent. HDGF immunostaining was found in the nucleus (20-95 percent) as well as in the cytoplasm (weak: 16; intermediate: 17; strong: 19). Upregulation of nuclear HDGF levels existed in increased cytoplasmic HDGF levels (P < 0.001). Nuclear HDGF levels were positively correlated with tumor mitotic count (P < 0.001), tumor size (P = 0.002), PCNA (P < 0.001), Ki-67 (P = 0.049), cellular pleomorphism (P = 0.029), and increased National Institutes of Health risk level (P = 0.037). Cytoplasmic HDGF levels were also correlated with PCNA (P = 0.001), tumor mitotic count (P = 0.001), high cellular pleomorphism (P = 0.001), and increased NIH risk (P = 0.043). Kaplan-Meier analyses revealed that patients with high nuclear HDGF (P < 0.001) or cytoplasmic levels (P = 0.001) had shorter disease-free survival than patients with low HDGF levels. Like tumor mitotic count, nuclear HDGF was an independent prognostic factor for patients with colorectal stromal tumors. CONCLUSIONS: This study provides clinicopathologic correlations and prognostic prediction of HDGF expression for the relatively rare colorectal stromal tumors.