We evaluated the prognostic implication of circulating microRNA (miR)-21, miR-26a, and miR-29a in hepatocellular carcinoma (HCC) patients who underwent curative treatment.

The study included 120 hepatitis B virus-related HCC patients who underwent hepatic resection (n=63) or radiofrequency ablation (n=57). MiR-21, miR-26a, and miR-29a expression levels in pretreatment plasma and several clinical variables were analyzed to identify prognostic bio-markers.

Old age, low albumin level, low platelet count, advanced tumor stage (modified Union for International Cancer Control stages III, IV), low miR-26a (hazard ratio [HR]=1.72; 95% confidence interval [CI]=1.04–2.83; P=0.035), and low miR-29a (HR=1.75; 95% CI=1.04–2.94; P=0.035) were identified as independent risk factors for predicting poor disease-free survival. Low miR-21, miR-26a, and miR-29a were associated with poor liver transplantation (LT)-free survival in the univariate analysis. Multivariate Cox regression analysis showed that low miR-26a (HR=3.41; 95% CI=1.32–8.82; P=0.011) and low miR-29a (HR=2.75; 95% CI=1.10–6.85; P=0.030), low platelet count, and advanced tumor stage were significantly associated with poor LT-free survival. Remarkable correlation was found between miR-26a and miR-29a (Spearman's rho=0.734, P<0.001).

Pretreatment levels of circulating miR-26a and miR-29a are independent prognostic markers for poor disease-free survival and LT-free survival in hepatitis B virus-related HCC patients.