Objective  To detect the expression of SVEP1, PKHD1 and P53 in primary liver cancer tissues by immunohistochemistry for predicting the recurrence of liver cancer.

  Methods  The clinical data of 103 patients with primary liver cancer who underwent surgical resection at Tianjin Medical University Cancer Institute and Hospital were gathered from January 2013 to January 2014 and analyzed retrospectively.Expression values of three different proteins were used to develop separate immunohistochemical scores for the prognosis of recurrence in patients.The patients were classified into either a high-risk or a low-risk group based on their immunohistochemical scores through ROC curve analysis.The difference in recurrence ratio between the two groups was then compared using the common research index of disease-free survival (DFS).

  Results  The median age of the total patients was 55 years (range 21-88 years), the median AFP level was 70.6(range 1.03-718840.0)μg/L, the median CA19-9 level was 22.89(range 0.6-1000.0) kU/L, and the median tumor size was 4.5(1.0-27.0) cm.The expression levels of SVEP1, PKHD1, and P53 in primary liver tumors were detected by immunohistochemistry and assigned separate immunohistochemical scores.The areas under the ROC curves of the immunohistochemical scores of SVEP1, PKHD1, and P53 were 0.861, 0.829, and 0.716, respectively.The critical values of SVEP1, PKHD1, and P53 were 4, 4, and 1 point, respectively (P < 0.001).The three-year DFS rates among the SVEP1 high-risk (expression ≤ 4 points) and low-risk groups (expression > 4 points) were 4.1% and 51.7%, respectively.Similarly, the three-year survival rates among the PKHD1 high-risk (expression ≤4 points) and low-risk groups (expression >4 points) were 5.3% and 51.9%, respectively.The three-year DFS rates among the P53 high-risk (expression >1 point) and the low-risk group (expression ≤1 point) were 6.3% and 27.3%, respectively.The survival differences between all the pairs were statistically significant (P < 0.001, < 0.001, and 0.003 respectively).When PKHD1 was used in combination with SVEP1, the ROC curve had an area of 0.897(P < 0.001) with a sensitivity of 76.5% and a specificity of 94.4%.

  Conclusions  The accuracy of P53 data for predicting primary liver cancer recurrence is insufficient and therefore it is not recommended for use.SVEP1 and PKHD1 data achieve sufficient accuracy for predicting the recurrence of primary liver cancer.Since SVEP1 data impart a higher specificity and PKHD1 data impart a higher sensitivity to the prognosis scores, the combined use of the two markers is better than being used individually.