Low levels of circulating microRNA-26a/29a as poor prognostic markers in patients with hepatocellular carcinoma who underwent curative treatment.

Summary Background/aims We evaluated the prognostic implication of circulating microRNA (miR)-21, miR-26a, and miR-29a in hepatocellular carcinoma (HCC) patients who underwent curative treatment. Methods The study included 120 hepatitis B virus-related HCC patients who underwent hepatic resection ( n  = 63) or radiofrequency ablation ( n  = 57). MiR-21, miR-26a, and miR-29a expression levels in pretreatment plasma and several clinical variables were analyzed to identify prognostic bio-markers. Results Old age, low albumin level, low platelet count, advanced tumor stage (modified Union for International Cancer Control stages III, IV), low miR-26a (hazard ratio [HR] = 1.72; 95% confidence interval [CI] = 1.04–2.83; P  = 0.035), and low miR-29a (HR = 1.75; 95% CI = 1.04–2.94; P  = 0.035) were identified as independent risk factors for predicting poor disease-free survival. Low miR-21, miR-26a, and miR-29a were associated with poor liver transplantation (LT)-free survival in the univariate analysis. Multivariate Cox regression analysis showed that low miR-26a (HR = 3.41; 95% CI = 1.32–8.82; P  = 0.011) and low miR-29a (HR = 2.75; 95% CI = 1.10–6.85; P  = 0.030), low platelet count, and advanced tumor stage were significantly associated with poor LT-free survival. Remarkable correlation was found between miR-26a and miR-29a (Spearman's rho = 0.734, P Conclusion Pretreatment levels of circulating miR-26a and miR-29a are independent prognostic markers for poor disease-free survival and LT-free survival in hepatitis B virus-related HCC patients.