Abstract: Objective The aim of this study was to explore the implications of hepatic homeobox gene C9 (HOXC9) and kinesin family member 4A (KIF4A) protein expression in patients with hepatocellular carcinoma (HCC). Methods 86 patients with HCC were enrolled in our hospital between January 2018 and January 2021, and all underwent hepatectomy. The patients with HCC were all followed-up for two years after operation. The cancerous and the adjacent non-cancerous tissues were collected, and the protein expressions of HOXC9 and KIF4A in tissues were detected by immunohistochemical staining. Results The intensified expression rates of HOXC9 and KIF4A in cancerous tissues were 69.8% and 51.2%, both significantly higher than 15.1% and 16.3% in adjacent liver tissues (P<0.05); the intensified expression rates of HOXC9 in 56 patients with low/moderate tumor cell differentiation, in 40 patients withⅡb/Ⅲb stages, in 38 patients with tumor capsule invasion and 37 patients with microvascular invasion were 78.6%, 85.0%, 71.1% and 83.8%, all significantly higher than 53.3%, 56.5%, 47.9% and 59.2% (P<0.05) in 30 patients with high tumor cell differentiation, in 46 patients with Ⅰa/Ⅱa stages, in 48 patients without tumor capsule invasion and in 49 patients without microvascular invasion; the intensified expression rates of KIF4A in low/moderate tumor cell differentiation, Ⅱb/Ⅲb stages, with tumor capsule invasion and microvascular invasion were 60.7%, 80.0%, 60.5% and 89.2%, also significantly higher than 33.3%, 26.1%, 43.8% and 22.4% (P<0.05) in their parallel adjacent non-cancerous tissues; at the end of two-year follow-up, 38 patients(44.2%)survived and 48 patients (55.8%) died; the overall survivals (OS) in 60 patients with intensified cancerous HOXC9 expression was 14.0(7.8, 26.7)mon, much shorter than [27.0(18.8, 30.5)mon, P<0.05] in 26 patients with weak HOXC9 expression; the OS in 44 patients with intensified cancerous KIF4A expression was 9.0(7.0, 26.3)mon, also significantly shorter than [15.3(26.0, 28.8) mon, P<0.05] in 42 patients with weak HOXC9 expression. Conclusion The upregulation of cancerous HOXC9 and KIF4A in patients with HCC might be correlated to the malignant quality of tumor cells, and to the poor prognosis.

Key words: Hepatoma, Hepatectomy, Homeobox gene C9, Kinesin family member 4A, Prognosis