Cathepsin A (CTSA) is overexpressed in various types of
cancer and is linked to poor clinical outcomes. However, the clinical application of CTSA in HCC has not been explored. In this study, we examined the
protein level of CTSA in the archived HCC samples from 161 patients by Immunohistochemistry (IHC). The high
protein level of CTSA was significantly correlated to the poor clinicopathological parameters, such as TNM stage, serum AFP level,
tumor differentiation,
liver cirrhosis, Child-Pugh class, vascular invasion,
tumor encapsulation,
tumor recurrence, and patient death. In addition, multivariate Cox regression analysis indicated that high CTSA expression was an independent prognostic factor of OS and RFS. We also analyzed the area under the curve (AUC) of the time-dependent receiver operating characteristic (ROC) of CTSA expression for 1-, 3-, and 5-year OS and RFS prediction. Furthermore, we constructed a nomogram that exhibited excellent prediction performance, which was validated by the calibration curve and decision curve analysis. Together, our study demonstrated that CTSA
protein level is strongly associated with poor clinical outcome of HCC patients and may be used as a potential diagnostic and prognostic
biomarker in HCC.