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The diagnostic and prognostic value of SALL 4 in hepatoblastoma
Author(s) -
Zhou Shengmei,
Venkatramani Rajkumar,
Gomulia Ellen,
Shillingford Nick,
Wang Larry
Publication year - 2016
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13005
Subject(s) - hepatoblastoma , immunostaining , biology , metastasis , pathology , immunohistochemistry , multivariate analysis , medicine , cancer
Aims To investigate the expression of spalt‐like transcription factor 4 ( SALL 4), a regulator of embryonal development, in three epithelial components of hepatoblastoma ( HB ) and the relationship between SALL 4 expression levels and patients’ clinicopathological features. Methods and results A total of 115 specimens from 79 patients with HB were selected for immunostaining of SALL 4. Nuclear staining was semi‐quantified using the immunoreactive score ( IS ; range: 0–12). SALL 4 expression was seen in all embryonal components (mean IS = 8.58) and in 41% of fetal components (mean IS = 0.78). No SALL 4 expression was seen in either small cell undifferentiated or mesenchymal components of HB . Neither chemotherapy nor metastasis altered SALL 4 expression significantly. High SALL 4 expression levels were associated significantly with decreased overall survival ( OS ) ( P = 0.004), event‐free survival ( EFS ) ( P = 0.003) and the presence of metastasis ( P = 0.049) on univariate analysis. Multivariate analysis identified SALL 4 as an independent prognostic predictor for OS ( P = 0.029). Conclusions SALL 4 is useful for subtyping HB , and high SALL 4 expression is associated with decreased survival in HB .