Significance of incorporation of DNMT1 and HLA-DRα with TNM staging in patients with hepatocellular carcinoma after curative resection

Hepatocellular carcinoma (HCC) is the most common type of hepatic cancer and is particularly a problem in China. Bio-molecular markers have been demonstrated to be of prognostic significance and might help predict tumor behavior. In our study, we aimed to assess the prognostic values of DNA methyltransferase 1 (DNMT1), HLA-DRα, and β-catenin, as well as the combined use of molecular biomarkers, clinicopathological parameters and the TNM staging system to find a method for superior prognostic performance for HCC by analyzing a Chinese HCC cohort. We revealed the significant prognostic roles of DNMT1 (OR: 2.570; 95% CI: 1.401-4.715; P = 0.002) and HLA-DRα (0.350; 0.189-0.616; 0.001), and further developed an estimation formula to predict prognosis in HCC patients after curative resection, based on TNM staging, operative blood loss, abnormal total bilirubin, DNMT1 and HLA-DRα. The receiver operating characteristic curve analysis showed that prediction from the multivariate logistic regression had an area of 0.847 and performed better than the conventional TNM staging system, as well as other current HCC staging systems. Our study demonstrated the prognostic values of DNMT1 and HLA-DRα in HCC patients after curative resection. Additionally, we developed a prognostic estimation formula featured better stratification ability than the conventional TNM staging and provided a practicable stratification method for HCC patients after curative resection.