DLX4 as a prognostic marker for hepatocellular carcinoma.

Distal-less homeobox gene 4 (DLX4) has been shown to play a role in carcinogenesis. The value of DLX4 in hepatocellular carcinoma (HCC) has not been fully investigated. Here, we sought to quantify the expression of DLX4 in association with the clinicopathological features and prognosis in hepatocellular carcinoma (HCC). We examined DLX4 expression in 45 HCC tissues and matched adjacent noncancerous tissues by quantitative RT-PCR (qRT-PCR) and Western blotting. Furthermore, 226 HCC samples were analyzed for DLX4 expression by immunohistochemistry. The expression of DLX4 was significantly elevated in HCC tissues in comparison with that in adjacent non-cancerous tissues (P<0.01). The high expression of DLX4 in HCC was significantly correlated with tumor size, histopathologic classifications, and serum alpha-fetoprotein (AFP). Kaplan-Meier survival analysis revealed that increased expression of DLX4 correlated with poor clinical outcomes of HCC patients (P<0.01). Subsequent multivariate analysis showed that DLX4 expression was an independent prognostic biomarker for overall survival of HCC patients. These results suggest that high expression of DLX4 predicts HCC prognosis, and DLX4 may be potentially an important therapeutic target for HCC.