Research over EZH2, Bmi-1, HSP70, CAP2 and proteins of glutamin synthetase with immunohistochemical method for the case of hepatocellular carcinoma and evaluation of the symptoms and their role in the agressive clinical behaviour

Introduction-Objective: Hepatocellular carcinoma, generally developing with chronical liver disease or on the basis of cirhosis; it is the tumor that takes place in the very first rows among the most deadly tumors that are encountered in the world as primary tumor of liver. Being the 5th most encountered cancer type in the world, it takes place in the third row of deaths caused by cancer. In this study for the hepatocellular carcinoma, we aimed to evaluate EZH2, Bmi-1, HSP70, GS and CAP2 proteins? expression and its effect over agressive clinical behaviour. Meterial and Method: Some 50 of hepatocellular carcinoma cases that have been examined between 2007 and 2012 in the Department of Pathology of Medical Faculty of Cukurova University were included into this research and EZH2, Bmi-1, HSP70, GS and CAP2 antibodies have been applied with the immunohistochemical method. Symptoms: 41 (82 %) of the patients who took place in the research were men and 9 (18 %) were women. 29 of the patients have died and their life time has been figured as 30±3 (24-37) months. Vein invasion has existed in 22 (44%) of the patients; while average life time for those who were in the group with invasion was 16±3 months, and for those who did not have invasion, the figure was 36±4 months and this outcome (p=0.019) has statistically been found meaningful. With Glutamine Synthetase (GS), low level of expression was found in 22 (44 %) of the cases, and high level of expression in 28 (56%) of the cases. For the cases with high level of expression, the estimated average life time was 15±2 months; and for the cases with low level of expression with GS, this figure was found as 38±4 months (p=0.018). With Bmi-1, low level of expression was found in 32 (64%) of the cases, and high level of expression in 18 (36%) of the cases. When Bmi-1 and life time was compared, the avarage life time for the group with high level of expression was found to be shorter (p=0.008). When Bmi-1 results and tumor diameter were compared, the tumor diameter was found to be bigger for the group with high level of expression (p=0.037). The level of Bmi-1 expression for the group with vein invasion was found to be higher (p=0.004). With EZH2, low level of expression was found in 36 (72 %) of the cases, and high level of expression, in 14 (28 %) of the cases. It is learned that 23 of 36 patients with low level expression, and 6 of 14 patients with high level expression have died. The corelation between EZH2 expression levels and life time of the patients is statistically meaningful (p=0.034). Discussion-Conclusion: This study has shown that it can be used as an indicator for the diagnosis of Hepatocellular carcinoma and its prognostic follow-up with GS, EZH2 and Bmi1. It has been seen that the higher the level of these proteins? expression, the shorter the life time gets. It is found that there is a clear positive correlation between GS, EZH2 and Bmi-1 expression and HSK developement and its malign behaviour. Thereby, GS, EZH2 and Bmi-1 can be target molecules in the developement of novel treatment strategies against HSK. Keywords: Hepatocellular carcinoma, GS, EZH2, Bmi-1, Immunohistochemical