Volume 152, Issue 6, Pages 1383-1394 (May 2017) Genome-Wide Association Study Identifies TLL1 Variant Associated With Development of Hepatocellular Carcinoma After Eradication of Hepatitis C Virus Infection  Kentaro Matsuura, Hiromi Sawai, Kazuho Ikeo, Shintaro Ogawa, Etsuko Iio, Masanori Isogawa, Noritomo Shimada, Atsumasa Komori, Hidenori Toyoda, Takashi Kumada, Tadashi Namisaki, Hitoshi Yoshiji, Naoya Sakamoto, Mina Nakagawa, Yasuhiro Asahina, Masayuki Kurosaki, Namiki Izumi, Nobuyuki Enomoto, Atsunori Kusakabe, Eiji Kajiwara, Yoshito Itoh, Tatsuya Ide, Akihiro Tamori, Misako Matsubara, Norifumi Kawada, Ken Shirabe, Eiichi Tomita, Masao Honda, Shuichi Kaneko, Sohji Nishina, Atsushi Suetsugu, Yoichi Hiasa, Hisayoshi Watanabe, Takuya Genda, Isao Sakaida, Shuhei Nishiguchi, Koichi Takaguchi, Eiji Tanaka, Junichi Sugihara, Mitsuo Shimada, Yasuteru Kondo, Yosuke Kawai, Kaname Kojima, Masao Nagasaki, Katsushi Tokunaga, Yasuhito Tanaka  Gastroenterology  Volume 152, Issue 6, Pages 1383-1394 (May 2017) DOI: 10.1053/j.gastro.2017.01.041 Copyright © 2017 AGA Institute Terms and Conditions

Figure 1 Cumulative incidence of HCC occurring after the eradication of HCV by IFN-based therapy according to rs17047200 genotype in patients of the discovery GWAS, the replication cohort and both combined. HR (95% CI) up to 10 years after the end of treatment were calculated by the Cox proportional hazard method. P values were calculated by log-rank testing. Data of subjects whose genotypes were not determined were excluded. Gastroenterology 2017 152, 1383-1394DOI: (10.1053/j.gastro.2017.01.041) Copyright © 2017 AGA Institute Terms and Conditions

Figure 2 Cumulative incidence of HCC after the eradication of HCV by interferon-based therapy according to risk factors in patients with mild (A) and advanced hepatic fibrosis (B). HR (95% CI) up to 10 years after the end of treatment were calculated by the Cox proportional hazard method. P-values were calculated by log-rank testing. Data of subjects whose genotypes were not determined were excluded. Post, post-treatment (24 weeks after the end of treatment). Gastroenterology 2017 152, 1383-1394DOI: (10.1053/j.gastro.2017.01.041) Copyright © 2017 AGA Institute Terms and Conditions

Figure 3 Gene expression levels of TLL1/BMP1 (Tll1/Bmp1) in human hepatic stellate cells and CDAA-fed hepatic fibrosis model rats. (A) Human stellate cells (HHSteC) were treated with human recombinant TGF-β1 (5 ng/mL) or mock-treated 6 hours after seeding, then harvested 72 hours after seeding (Supplementary Figure 9). The relative levels of TLL1/BMP1 mRNA were normalized to those of cells cultured in media with supplement (black bar). Three independent experiments were carried out in triplicate. Data represent mean ± SEM (bars: n = 3 per group). (B) Pathologic hepatic fibrosis stage by Heidenhain's azan staining in rats. CSAA 10W: a CSAA diet was fed for 10 weeks, showed METAVIR fibrosis stage F0; CDAA 10W/CDAA 30W: CDAA diet was fed for 10/30 weeks, showed F2/F3−4. (C) Relative Tll1/Bmp1 mRNA levels were normalized to those in CSAA 10W. Data represent mean ± SEM (bars: n = 5 per group). P values were calculated by 1-way analysis of variance, followed by Tukey multiple comparison testing (∗P < .05; ∗∗P < .01; ∗∗∗P < .001). Gastroenterology 2017 152, 1383-1394DOI: (10.1053/j.gastro.2017.01.041) Copyright © 2017 AGA Institute Terms and Conditions

Figure 4 TLL1 mRNA expression levels in liver tissues of patients with chronic hepatitis C and in those developing hepatocellular carcinoma after achieving SVR. (A) TLL1 mRNA expression levels in normal liver (NL) and liver tissues of chronic hepatitis C (CHC) patients according to METAVIR fibrosis stage. Boxes represent the interquartile range of the data. The lines across boxes and the numbers indicate the median values. The hash marks above and below boxes indicate the 90th and 10th percentiles for each group, respectively. P values were calculated by Kruskal−Wallis test, followed by Steel-Dwass’ multiple comparison testing. (B) Left panel: TLL1 mRNA expression levels in tumor (T) and the surrounding nontumor (NT) tissues in patients who developed HCC after achieving SVR. Data represent mean ± SD. P values were calculated by paired t testing. Right panel: TLL1 mRNA expression levels in NT tissues according to METAVIR fibrosis stage. Data represent in the same manner as (A). P values were calculated by Mann−Whitney U testing. Gastroenterology 2017 152, 1383-1394DOI: (10.1053/j.gastro.2017.01.041) Copyright © 2017 AGA Institute Terms and Conditions