RNA binding protein ELAVL1 is associated with severity and prognosis of hepatocellular carcinoma patients: A retrospective study

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which is characterized by a lack of sensitive and specific biomarkers. This study investigates the association between ELAV-like RNA binding protein 1 (ELAVL1) and HCC patient outcomes. This retrospective study encompassed 108 HCC patients who reported to Wuhan Fourth Hospital and Tongji Hospital, China, from January 2016 to August 2020. Clinical data collected included age, sex, body mass index (BMI), comorbidities, tumor-node-metastasis (TNM) stage, Barcelona Clinic Liver Cancer (BCLC) stage, and lymphatic metastasis. All patients received routine follow-up for survival and recurrence status ranged from 36 to 60 months. The serum levels of ELAVL1 were tested using enzyme-linked immuno-sorbent assay (ELISA). Levels of total bilirubin, alanine aminotransferase (ALT), aspartate transaminase (AST), HCC-related biomarkers of alpha fetoprotein (AFP), α-L-fucosidase (AFU), and carcinoembryonic antigen (CEA) were recorded. Our findings revealed a significantly higher expression of ELAVL1 in patients presenting with TNM stages III-IV, BCLC stages C-D, lymphatic metastasis, as well as deceased and recurrent patients. Receiver operating characteristic (ROC) curves showed that the areas under the curve (AUCs) for ELAVL1 in predicting mortality, recurrence and poor prognosis (defined as mortality or recurrence) in HCC patients were 0.818, 0.732 and 0.827, respectively. Patients with higher expression of ELAVL1 showed significantly higher frequencies of TNM III-IV stages, BCLC D stage, lymphatic metastasis, higher mortality, and recurrence ratio, as well as higher AFP and CEA levels. ELAVL1 was positively correlated with levels of AFP and CEA. Higher BCLC stage, lymphatic metastasis, age, AFP, and ELAVL1 were independent risk factors for poor prognosis of HCC patients. Higher serum levels of ELAVL1 are associated with worse clinical outcomes and poorer prognosis in ‑HCC patients.