High expression of CXCR7 combined with Alpha fetoprotein in hepatocellular carcinoma correlates with extra-hepatic metastasis to lung after hepatectomy.

The lung is the most frequent metastatic site of hepatocellular carcinoma (HCC), negatively impacting on survival rates. In this study, we evaluated the prognostic role of the chemokine receptor CXCR7 in lung metastasis of HCC after hepatectomy, using immunohistochemical detection on tissue microarrays of HCCs, with and without lung metastasis. Using three categories based on staining characteristics, patients with high CXCR7 expression demonstrated a shorter time to development of lung metastasis compared with patients with low CXCR7 expression (log-rank test) with no effet on overall survival. Analysis of tissue adjacent to tumor showed patients with microvascular invasion to have higher CXCR7. Stratification based on alpha fetoprotein level >20 ng/ml also showed high expression of CXCR7 to be a strong independent prognostic factor. These findings suggest that high expression of CXCR7 in HCCs with elevated alpha fetoprotein levels correlates with metastasis to lung and poor survival after hepatectomy, indicating potential use as a prognostic factor.