title: The expression of cytokeratin 19 in lymph nodes was a poor prognostic factor for hepatocellular carcinoma after hepatic resection.
abstract: BACKGROUND
  The expression of CK19 in primary hepatocellular carcinoma (HCC) is associated with a poor outcome. However, few studies have investigated the expression profile of CK19 in regional lymph nodes (LNs) of HCC after hepatic resection. The purpose of this study was to evaluate the expression of CK19 in primary liver tumor and regional LNs of HCC with and without lymph node metastasis (LNM).
  
  
  METHODS
  The expression of CK19 in patients with (n = 16) and without LNM (n = 26) was examined using immunohistochemical staining. Both the primary tumor and LN specimen were studied for their CK19 expression. Clinico-pathological variables and prognostic significance were analyzed.
  
  
  RESULTS
  Immunopositivity of CK19 in primary liver tumor was significantly correlated with LNM (P = 0.005) and tumor non-encapsulation (P <0.005). Univariate analysis showed that CK19 expression in primary liver tumor, CK19 expression in regional LN, vascular invasion, daughter nodules, positive resection margin and American Joint Committee on Cancer (AJCC) tumor stage significantly decreased overall survival. Multivariate analysis demonstrated that daughter nodules (P = 0.001) and CK19 expression in regional LN (P = 0.002) were independent prognostic factors for overall survival.
  
  
  CONCLUSIONS
  This study showed that CK19 expression in regional LN of HCC was associated with LNM and an extremely poor outcome after operation. It is of clinical significance to identify these patients at risk for more aggressive HCC, and multi-modality treatment could be helpful to improve their dismal outcome.
authors.affiliation: The Department of Surgery, Chang Gung Memorial Hospital, No 5 Fusing Street, Taoyuan County, Gueishan 333, Taiwan.
authors.forename: Chao-Wei
authors.initials: CW
authors.lastname: Lee
authors.forename: Wen-Ling
authors.initials: WL
authors.lastname: Kuo
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Yu
authors.forename: Tse-Ching
authors.initials: TC
authors.lastname: Chen
authors.forename: Chi-Neu
authors.initials: CN
authors.lastname: Tsai
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lee
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D053539:Keratin-19 / Q000378:metabolism*; D008113:Liver Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes / Q000378:metabolism* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D053539:Keratin-19