Objective  To explore the correlation between expression of secretory clusterin (sCLU) and postoperative survival prognosis in paracancerous liver tissues of patients with resectable hepatocellular carcinoma (HCC).

  Methods  Serum samples, resected tumor tissues and paracancerous liver tissues were collected from 208 HCC patients with hepatic resection. Serum sCLU level was detected by enzyme-linked immunosorbent assay; sCLU expressions in resected tissues and paracancerous liver tissues were detected by immunohistochemistry.

  Results  The median follow-up time was 58.0 months in all the patients, and the preoperative serum sCLU level was 89.11 (63.23, 119.47) μg/mL. There was no correlation between serum sCLU level and tumor staging. There was no significant difference in disease-free survival rate between patients with high level sCLU (≥89.11 μg/mL) and low level sCLU (< 89.11 μg/mL)(P>0.05). The expression of sCLU protein was positive in 115 tumor tissues (55.29%) and 81 paracancerous liver tissues (38.94%). There was no significant difference in disease-free survival rate between patients with positive and negative expression of sCLU protein in tumor tissues (Log-rank χ²=1.763, P=0.184). The postoperative disease-free survival rate was significantly lower in patients with positive expression of sCLU protein in paracancerous liver tissue (Log-rank χ²=9.853, P=0.002). Multivariate Cox proportional hazards model analysis showed that the positive expression of sCLU protein in paracancerous liver tissue was an independent risk factor for disease-free survival and overallsurvival of HCC patients (P < 0.05).

  Conclusion  In patients with resectable HCC, the positive expression of sCLU protein in paracancerous liver tissue indicates that the disease-free survival and overall survival are poor, and sCLU can be used as an effective target to prevent tumor recurrence after HCC resection.