Cytokeratin 19 expression in hepatocellular carcinoma predicts early postoperative recurrence
Cytokeratin 19 expression in hepatocellular carcinoma predicts early postoperative recurrence
复制标题
DOI：
10.1111/j.1349-7006.2003.tb01366.x
复制
发表时间：
2003-10-01
期刊：
影响因子：
5.7
通讯作者：
Hirohashi, K
中科院分区：
文献类型：
--
作者：
Uenishi, T;Kubo, S;Hirohashi, K
对因胆管标志物（CK 7和CK 19）阳性肝细胞癌（HCC）接受根治性手术的患者的临床病理特征和术后结局进行了研究。157例HCC中，93例CK 7（-）CK 19（-），49例CK 7（+）CK 19（-），1例CK 7（-）CK 19（+），14例CK 7（+）CK 19（+）。表达水平的半定量分析表明CK 7和CK 19表达之间存在显著相关性。在各种临床病理参数中，肿瘤分化程度与CK 7和CK 19表达显著相关。所有15例CK 19阳性HCC患者也有抗HBc。Log-rank检验显示CK 7表达、CK 19表达、天冬氨酸转氨酶（AST）活性升高、白蛋白浓度降低、门脉浸润、肝内转移和严重纤维化。（肝硬化）降低了无瘤生存率。多因素分析显示，CK 19表达、肝内转移和严重纤维化是术后复发的独立预测因素，而CK 7表达不是。15例CK 19阳性HCC患者中有12例在术后2年内肿瘤复发，早期复发率显著高于CK 19阴性HCC。CK 19阳性的HCC患者肝外病变，尤其是淋巴结转移的发生率明显增高。这些发现表明，CK 19表达是由于侵袭性增加而导致的早期术后复发的预测因子。
Clinicopathologic features and postoperative outcomes were investigated for patients who underwent curative surgery for biliary marker (CK7 and CK19)-positive hepatocellular carcinoma (HCC). Of 157 HCCs, 93 were CK7(-)CK19(-), 49 were CK7(+)CK19(-), 1 was CK7(-)CK19(+), and 14 were CK7(+)CK19(+). Semiquantitative analysis of expression levels demonstrated a significant correlation between CK7 and CK19 expression. Of various clinicopathologic parameters, tumor differentiation exhibited a significant correlation with CK7 and CK19 expression. All 15 patients with CK19-positive HCC also had anti-HBc. Log-rank test revealed that CK7 expression, CK19 expression, high aspartate aminotransferase (AST) activity, low albumin concentration, portal invasion, intrahepatic metastasis, and severe fibrosis. (cirrhosis) reduced the tumor-free survival rate. Multivariate analysis demonstrated that CK19 expression, intrahepatic metastasis, and severe fibrosis were independent predictors of postoperative recurrence, while CK7 expression was not. Twelve of 15 patients with CK19-positive HCC had tumor recurrence within 2 years after surgery, a significantly higher incidence of early recurrence than for CK19-negative HCC. The incidence of extrahepatic disease, especially lymph node metastasis, was significantly higher for patients with CK19-positive HCC. These findings indicate that CK19 expression is a predictor of early postoperative recurrence due to increased invasiveness.