Combined Low miR-34s are associated with unfavorable prognosis in Children with Hepatoblastoma: A Chinese Population-based Study

Abstract Purpose The aim of this study is to identify the association between miR-34s family and the prognosis of HB in a large Asian cohort and to explore the interaction of miR-34s with other independently risk factors in the process of affecting prognosis of HB. Methods We retrospectively reviewed 78 children with HB (36 female, 42 male) managed in our institution between 2009 and 2014. The expression of miR-34s were detected by real-time PCR. Prognostic factors were evaluated using Kaplan-Meier curves and Cox proportional hazards models. Results For the entire cohort of 76 patients, The normalized real-time PCR results showed that all three miRNAs were deregulated in tumor tissues as compared with corresponding noncancerous tissue samples. Descriptive survival statistics and Kaplan-Meier curves suggested that AFP levels, metastases, vascular invasion, PRETEXT stage and miR-34s had prognostic significance in this relatively selected cohort. After that we made miR-34s into different combinations. The results demonstrated that combined low miR-34a and miR-34b(HR:2.212, P = 0.016), combined low miR-34a and miR-34c(HR:1.984, P = 0.025) and combined low miR-34a, miR-34b and miR-34c(HR:3.569, P = 0.001)were independent prognostic factors of HB. We further conduct stratified analysis of the impact of other identified risk factors on the combined low of three miR-34s. Conclusions In this study, we found that miR-34s were deregulated in tumor tissues compared with corresponding noncancerous tissue samples. We also confirmed that combined Low miR-34s is an independent prognostic factor related with HB.