Which statement about Beclin-1 H-scores is correct?

• A. Primary tumors had the highest Beclin-1 H-scores of the three groups.
• B. Recurrent tumors had the lowest Beclin-1 H-scores.
• C. Beclin-1 H-scores increased from primary to metastasis, with primary lowest, metastases highest.
• D. Beclin-1 H-scores did not differ among groups.

Answer: (C)

Beclin-1 is a key regulator of autophagy, and the H-score is a way to quantify how much Beclin-1 protein is present in tissue by combining staining intensity and the percentage of positive cells. In this scenario, Beclin-1 expression is lowest in primary tumors and highest in metastases, with recurrent tumors in between. That pattern shows a progressive increase in Beclin-1 as the tumor advances, suggesting autophagy becomes more active in metastatic lesions. Since higher H-scores reflect more Beclin-1, the statement that Beclin-1 H-scores increase from primary to metastasis—with the primary lowest and metastases highest—best fits the data. The other patterns—primary higher than metastasis, recurrent being the lowest, or no difference among groups—do not match the observed trend.