To investigate the relationship between the expression of arachidonic acid 15-lipoxygenase (ALOX15) in adjacent tissues and clinical prognosis of patients with hepatocellular carcinoma (HCC) after radical resection.

Clinical data of 306 patients with HCC who underwent radical resection in the First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2016 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 259 patients were male and 47 female, aged from 10 to 79 years, with a median age of 52 years. The expression level of ALOX15 in adjacent tissues was determined by immunohistochemical staining and the degree of staining was scored. According to the optimumcut-off value of ALOX15 expression level, all patients were divided into the low (n=222) and high expression groups (n=84). Survival analysis was conducted by Kaplan-Meier method and Log-rank test. The prognostic factors of HCC patients were identified by Cox proportional hazard regression model.

ALOX15 staining was mainly observed in cytoplasm and cell membrane of adjacent tissues, and positive cells were primarily distributed in hepatocyte stroma. There were 22 cases with high expression of ALOX15 in adjacent tissues and 84 cases with high expression of ALOX15. The postoperative 1-, 3- and 5-year overall survival rates of patients with low expression of ALOX15 were 91.8%, 83.0% and 77.6%, and 83.7%, 67.3% and 60.9% for the tumor-free survival rates, respectively. The postoperative 1-, 3- and 5-year overall survival rates of those with high expression of ALOX15 were 90.9%, 54.5% and 44.5%, and 65.5%, 40.3% and 22.9% for the tumor-free survival rates, respectively. The postoperative overall survival and tumor-free survival in the low ALOX15 expression group were significantly better than those in the high ALOX15 expression group (χ²=32.223, 36.408; P<0.05). Multivariate Cox analysis showed that the immunoreactive score of ALOX15>27 was an independent risk factor for postoperative overall survival and tumor-free survival (HR=2.986, 2.350; P<0.05).

High expression of ALOX15 in adjacent tissues is an independent risk factor for clinical prognosis of HCC patients after radical resection. Patients with high expression of ALOX15 obtain poor prognosis and are prone to postoperative recurrence.