{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:49:20Z","timestamp":1760402960641,"version":"build-2065373602"},"reference-count":62,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Hepatocellular carcinoma (HCC) is a prevalent malignancy with high mortality, often arising in the context of chronic liver diseases. Heme oxygenase-1 (HO-1), an inducible enzyme involved in heme degradation, has been implicated in both hepatoprotection and tumor progression. This study evaluates the expression of HO-1 in HCC and its association with clinicopathological features and patient survival. Materials and Methods: We retrospectively analyzed 58 HCC cases diagnosed between 2018 and 2023 at \u201cSf. Spiridon\u201d Emergency County Hospital, Iasi. HO-1 expression was assessed immunohistochemically and quantified using a semi-quantitative immunoreactivity score (IRS). Statistical correlations between HO-1 expression and clinical, pathological, and survival parameters were evaluated using univariate analysis, ROC curves, and Kaplan\u2013Meier survival models. Results: High HO-1 expression (IRS &gt; 1) was significantly associated with hepatitis C virus etiology (p = 0.004, V = 0.381), vascular invasion (p = 0.019, V = 0.309) and perioperative anticoagulant therapy (p = 0.007, V = 0.352). However, HO-1 expression did not correlate with overall survival (OS). In contrast, solid growth pattern (p = 0.030) and serum \u03b1-fetoprotein levels of 10\u201399 ng\/mL (p = 0.022) were negatively associated with OS. Conclusions: HO-1 expression in HCC was found to be associated with vascular invasion, but not with overall survival. While this may indicate a potential link to certain aggressive tumor features, the overall role of HO-1 in HCC biology remains unclear. These findings suggest that HO-1 should be considered an exploratory rather than definitive prognostic marker, and further research is warranted to clarify its function and potential utility, including investigation of its detectability in biological fluids for non-invasive monitoring.<\/jats:p>","DOI":"10.3390\/life15101589","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:13:27Z","timestamp":1760361207000},"page":"1589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heme Oxygenase-1 Expression as a Prognostic Marker in Early-Stage HCC Undergoing Resection or Liver Transplantation"],"prefix":"10.3390","volume":"15","author":[{"given":"Ramona","family":"Cadar","sequence":"first","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9865-5114","authenticated-orcid":false,"given":"Alin Mihai","family":"Vasilescu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Trofin","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru Grigorie","family":"Nastase","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9260-6322","authenticated-orcid":false,"given":"Mihai","family":"Zabara","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0891-5961","authenticated-orcid":false,"given":"Cristina","family":"Muzica","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, Sf. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7539-9453","authenticated-orcid":false,"given":"Corina Lupascu","family":"Ursulescu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Radiology Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0194-7832","authenticated-orcid":false,"given":"Mihai","family":"Danciu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Departament of Pathology, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7968-7172","authenticated-orcid":false,"given":"Andrei","family":"Pascu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Departament of Pathology, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulian","family":"Buzincu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Anesthesiology and Intensive Care Department, Clinical Emergency County Hospital \u201cSt. Spiridon\u201d Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4761-4133","authenticated-orcid":false,"given":"Delia","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Departament of Pathology, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2191-6697","authenticated-orcid":false,"given":"Ianole","family":"Victor","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Departament of Pathology, Prof. dr. N. Oblu University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian Dumitru","family":"Lupascu","sequence":"additional","affiliation":[{"name":"Surgical Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3350\/cmh.2022.0365","article-title":"Global incidence and prevalence of nonalcoholic fatty liver disease","volume":"29","author":"Teng","year":"2023","journal-title":"Clin. Mol. 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