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Background <p>The implications of AKT and phospho-AKT (p-AKT) expression patterns in various malignancies remain a subject of considerable scientific interest. Current evidence regarding their association with hepatocellular carcinoma (HCC) progression by immunohistochemical (IHC) analyses demonstrates significant inconsistencies.</p> Objective <p>This study aimed to evaluate the clinical significance of AKT and p-AKT expression in HCC patients, with specific emphasis on their correlations with clinicopathological parameters, to provide insights to inform clinical decision-making.</p> Method <p>We conducted a systematic literature search across six major electronic databases through February 25, 2024, using search terms related to AKT, p-AKT, IHC, and hepatocellular carcinoma. Eligible studies were selected through strictly screening according to the inclusion/exclusion criteria, with methodological quality assessed via the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using Stata 15.0 software.</p> Result <p>A total of 17 eligible publications with a total of 1595 patients were analyzed in the meta-analysis. AKT overexpression in HCC correlated with advanced TNM stage (OR = 3.698, 95% CI = 1.224–11.167), vascular invasion (4.121;1.483–11.447), lymph node metastasis (2.958;1.188–7.367), capsule integrity compromise (2.491;1.192–5.206), and portal vein cancer thrombus (6.919;1.240-38.619). p-AKT expression in HCC demonstrated associations with tumor grade (2.789;1.379–5.641), TNM stage progression (3.058;1.779–5.255), tumor size &gt; 5&#xa0;cm (2.507;1.056–5.953), portal vein cancer thrombus (4.280;1.798–10.188), and cirrhotic history (1.933;1.226–3.047). For results with significant heterogeneity, we used a random-effects model to pool the effect sizes and conducted subgroup analyses as well as meta-regression analyses. The results indicated that some differences between p-AKT and antibody thresholds were also observed in the subgroup of antibody thresholds, which deserves further research.</p> Conclusion <p>Expression of AKT is associated with TNM stages, venous vascular invasion, metastasis of lymph node, integrity of capsule and portal vein cancer thrombus. And p-AKT expression is associated with histological grades, portal vein cancer thrombus, liver cirrhosis, tumor size and TNM stages. This synthesis establishes AKT as a biomarker for advanced HCC features including metastatic potential and vascular complications, while p-AKT demonstrates dual associations with both tumor progression markers and underlying hepatic pathology.</p>

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Clinicopathological significance of AKT and phosphorylated AKT expression in hepatocellular carcinoma: A Meta-Analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Yongjing Ma,
  • Mengfan Chen,
  • Zhong Xu

摘要

Background

The implications of AKT and phospho-AKT (p-AKT) expression patterns in various malignancies remain a subject of considerable scientific interest. Current evidence regarding their association with hepatocellular carcinoma (HCC) progression by immunohistochemical (IHC) analyses demonstrates significant inconsistencies.

Objective

This study aimed to evaluate the clinical significance of AKT and p-AKT expression in HCC patients, with specific emphasis on their correlations with clinicopathological parameters, to provide insights to inform clinical decision-making.

Method

We conducted a systematic literature search across six major electronic databases through February 25, 2024, using search terms related to AKT, p-AKT, IHC, and hepatocellular carcinoma. Eligible studies were selected through strictly screening according to the inclusion/exclusion criteria, with methodological quality assessed via the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using Stata 15.0 software.

Result

A total of 17 eligible publications with a total of 1595 patients were analyzed in the meta-analysis. AKT overexpression in HCC correlated with advanced TNM stage (OR = 3.698, 95% CI = 1.224–11.167), vascular invasion (4.121;1.483–11.447), lymph node metastasis (2.958;1.188–7.367), capsule integrity compromise (2.491;1.192–5.206), and portal vein cancer thrombus (6.919;1.240-38.619). p-AKT expression in HCC demonstrated associations with tumor grade (2.789;1.379–5.641), TNM stage progression (3.058;1.779–5.255), tumor size > 5 cm (2.507;1.056–5.953), portal vein cancer thrombus (4.280;1.798–10.188), and cirrhotic history (1.933;1.226–3.047). For results with significant heterogeneity, we used a random-effects model to pool the effect sizes and conducted subgroup analyses as well as meta-regression analyses. The results indicated that some differences between p-AKT and antibody thresholds were also observed in the subgroup of antibody thresholds, which deserves further research.

Conclusion

Expression of AKT is associated with TNM stages, venous vascular invasion, metastasis of lymph node, integrity of capsule and portal vein cancer thrombus. And p-AKT expression is associated with histological grades, portal vein cancer thrombus, liver cirrhosis, tumor size and TNM stages. This synthesis establishes AKT as a biomarker for advanced HCC features including metastatic potential and vascular complications, while p-AKT demonstrates dual associations with both tumor progression markers and underlying hepatic pathology.