Clinicopathological and Prognostic Significance of OCT4 Expression in Hepatocellular Carcinoma: An Immunohistochemical Study

Background: OCT4 is a pluripotency-associated transcription factor implicated in tumour stemness, progression and recurrence, but its clinicopathological and prognostic significance in hepatocellular carcinoma requires further evaluation. The objective is to evaluate OCT4 expression in hepatocellular carcinoma and determine its association with clinicopathological and prognostic outcomes, thereby assessing its potential role as a biomarker of tumour aggressiveness and prognosis. Material and Methods: This single-centre observational analytical study included 55 histopathologically confirmed cases of hepatocellular carcinoma from the Department of Pathology, Fathima Institute of Medical Sciences, Kadapa, Andhra Pradesh, India. Results: The mean age was 55.8 ± 11.4 years, with male predominance (76.4%). HBsAg positivity was present in 56.4%, cirrhosis in 61.8%, and AFP >400 ng/mL in 41.8%. The mean tumour size was 5.9 ± 2.4 cm; 54.5% had tumours >5 cm, 34.5% had multiple tumours, and vascular invasion was present in 40.0%. High OCT4 expression was observed in 37 patients (67.3%). It was significantly associated with tumour size >5 cm (67.6% vs 27.8%, p=0.009), multiple tumours (45.9% vs 11.1%, p=0.015), vascular invasion (p=0.019), poor differentiation (p=0.030), and advanced TNM stage (p=0.014). High OCT4 was associated with recurrence (56.8% vs 22.2%, p=0.022), lower 3-year OS (50.4% vs 88.5%), and lower 3-year RFS (41.7% vs 74.7%). Conclusion: High OCT4 expression was significantly associated with aggressive clinicopathological features, recurrence, and poorer survival outcomes, suggesting its potential utility as a prognostic biomarker in hepatocellular carcinoma.

Keywords: Hepatocellular carcinoma, OCT4, immunohistochemistry, tumour aggressiveness, recurrence-free survival, overall survival.