title: Keratin 19 protein expression is an independent predictor of survival in human hepatocellular carcinoma.
abstract: OBJECTIVE
  We aimed to assess the clinicopathological relevance and prognostic significance of expression of the hepatic progenitor cell markers keratin 19 (K19), epithelial cell adhesion molecule (EpCAM) and CD117 (c-KIT) in a White series of hepatocellular carcinoma (HCC).
  
  
  METHODS
  We evaluated the immunohistochemical expression of K19, EpCAM and CD117 in 89 surgical specimens of HCC from Greek patients (mean age 66.7±11.3 years, male 75.2%) followed up for 39.6±25.3 months.
  
  
  RESULTS
  K19, EpCAM and CD117 expression was detected in tumour cells of 10.11, 15.38 and 3.7% HCCs, respectively. Female sex was correlated with EpCAM immunohistochemical expression (P=0.035), whereas no other significant relationship with clinicopathological parameters was observed. K19 positivity tended to be correlated with microvascular invasion (P=0.054). In univariate analysis, K19 positivity and microvascular invasion were found to be associated with decreased recurrence-free survival (P<0.001 and P=0.004, respectively) and overall survival (P=0.002 and P=0.029, respectively). EpCAM and CD117 positivity was not correlated with patient survival. In multivariate analysis, K19 positivity emerged as an independent predictor of recurrence-free survival (odds ratio=7.84, 95% confidence interval=2.658-22.912, P<0.001) and overall survival (odds ratio=3.845, 95% confidence interval=1.401-10.549, P=0.009).
  
  
  CONCLUSIONS
  Our study confirms the prognostic significance of K19 expression in Caucasian patients with HCCs, providing further evidence that it may be used to stratify HCC according to tumour aggressiveness.
authors.affiliation: aLaboratory of Histology-Embryology b2nd Department of Internal Medicine c1st Department of Surgery d2nd Department of Surgery e1st Department of Pathology fDepartment of Pathology, Aretaieion Hospital, National & Kapodistrian University of Athens, Athens, Greece gDepartment of Gastroenterology, Chelsea and Westminster Hospital, London hInstitute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK iDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, USA.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Fatourou
authors.forename: John
authors.initials: J
authors.lastname: Koskinas
authors.forename: Despina
authors.initials: D
authors.lastname: Karandrea
authors.forename: Marina
authors.initials: M
authors.lastname: Palaiologou
authors.forename: Thalia
authors.initials: T
authors.lastname: Syminelaki
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
authors.forename: Efstathios
authors.initials: E
authors.lastname: Antoniou
authors.forename: Emanuel K
authors.initials: EK
authors.lastname: Manesis
authors.forename: Johanna
authors.initials: J
authors.lastname: Delladetsima
authors.forename: Dina
authors.initials: D
authors.lastname: Tiniakos
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry* / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015815:Cell Adhesion Molecules / Q000032:analysis; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D053539:Keratin-19 / Q000032:analysis*; D008113:Liver Neoplasms / Q000737:chemistry* / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D044465:White People
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule; D053539:Keratin-19; D019009:Proto-Oncogene Proteins c-kit