Research Paper|Volume 13, Issue 3|pp 3483—3500

Estradiol is significantly associated with prognosis in non-surgical liver cancer patients: from bench to bedside

Rangrang Wang¹, Yuan Liu¹, Hongze Sun¹, Tao Wang¹, Changcan Li², Junwei Fan¹, Zhaowen Wang¹

¹Department of General Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
²Department of General Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China

* Equal contribution

Received: June 1, 2020Accepted: October 29, 2020Published: January 10, 2021

https://doi.org/10.18632/aging.202280

Copyright: © 2021 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

There are rarely systematic studies to analyze the prognostic factors among non-surgical liver cancer patients. Whether there is a gender difference in the survival of non-surgical liver cancer patients and what may cause this difference is still unclear.

A total of 12,312 non-surgical liver cancer patients were enrolled in this study. Age, race, sex, grade, tumor TNM stage, marital status, tumor size, and histological type were independent risk factors in liver cancer and were confirmed in the validation cohort. Before menopause, females demonstrated a better mean survival probability than males (39.4±1.4 vs. 32.7±0.8 months, respectively; p<0.001), and continued in post-menopause. The results of differentially expressed genes (DEGs) and KEGG pathway analysis showed that there were significant differences in steroid hormone biosynthesis between male and female liver cancer patients. In vitro experiments revealed that estradiol inhibited the proliferation of hepatocellular cancer cell lines and increased apoptosis, but estrone exerted no effect.

In conclusion, gender differences in prognosis among non-surgical liver cancer patients were confirmed and attributable primarily to estradiol.