Serum AKR1B10 as an indicator of unfavorable survival of hepatocellular carcinoma

Background and Aims A large-scale multicenter study validated aldo–keto reductase 1B10 (AKR1B10) as a new serum marker of hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic value of serum AKR1B10 in HCC. Methods 273 naïve HCC patients enrolled for serum AKR1B10 tests were followed up for 2 years. Survival and clinical data were collected. Kaplan–Meier survival analysis and log-rank tests were used to estimate correlation of patient survival with serum AKR1B10. Univariate and multivariate COX regression analyses were used to evaluate the prognostic value of serum AKR1B10 level independently or in combination with other clinicopathological factors. α-fetoprotein (AFP) was analyzed in parallel for comparison. Results Serum AKR1B10 associated with tumor stage ( p = 0.012), size ( p = 0.004), primary tumor number ( p = 0.019), and Child–Pugh classification ( p = 0.003). HCC patients with a high level of serum AKR1B10 (≥ 267.9 pg/ml) had median survival (MS) of 25 months (95% confidence interval [CI] 20.788–29.212) vs. MS of 34 months (CI 28.911–39.089) in patients with normal serum AKR1B10 ( p < 0.001). Univariate and multivariate COX regression analyses showed that serum AKR1B10 level was an unfavorable prognostic marker of HCC independently (HR 1.830, 95% CI 1.312–2.552; p < 0.001) or in combination with other clinical factors (HR 1.883, 95% CI 1.264–2.806; p = 0.002), such as TNM stage, tumor size and portal invasion. In the same cohort of HCC patients, AFP exhibited prognostic value at a cut-off of 400 ng/ml, but not at 20 ng/ml and 200 ng/ml. Conclusions Serum AKR1B10 is a new prognostic marker of HCC, better than AFP.