title: Use of Cytokeratin-19 Concentration to Assess Early Recurrence and Prognosis of Hepatitis B Virus-Related Hepatocellular Carcinoma following Radical Resection in Patients with a Low Serum Alpha-Fetoprotein Concentration.
abstract: Cytokeratin 19 (CK-19) is a prognostic indicator of recurrence and metastasis of hepatocellular carcinoma (HCC) following radical resection. To investigate the role of CK-19 in assessment of early recurrence and prognosis in patients with hepatitis B virus (HBV)-related HCC following radical resection. In total, 235 patients with HBV-related HCC (age, 15-82 years; mean age, 54 ± 10 years) undergoing radical resection were screened for inclusion from January 2005 to December 2010. Malignant tissues and adjacent non-malignant tissues were sampled during surgery, and CK-19 and Ki-67 expression was determined by tissue microarray and immunohistochemistry. CK-19 mRNA levels in 30 randomly selected frozen HCC specimens were examined by reverse transcription polymerase chain reaction from January 2011 to June 2011. Correlations of CK-19 and Ki-67 expression with tumor recurrence, metastasis, disease-free survival (DFS), and overall survival (OS) were analyzed. Elevated CK-19 expression was correlated with early recurrence (P = 0.001), shorter DFS (P = 0.001), and reduced OS (P = 0.010). CK-19 expression was correlated with the Ki-67 index (P = 0.037), histological differentiation (P = 0.016), focal number (P = 0.044), and blood vessel tumor embolism (P = 0.002). Patients with metastasis within 1 year exhibited stronger CK-19 expression than did patients without metastasis (P < 0.05). Furthermore, early recurrence was associated with elevated CK-19 mRNA levels (χ2 = 5.761, P = 0.016).When confirmed by a low alpha-fetoprotein concentration (<400 μg/L), CK-19 expression in surgical biopsy specimens taken from patients with HCC during radical resection is an additional valuable indicator of early recurrence, distant metastasis, and poor prognosis in HBV-positive patients.
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Zu-Sen
authors.initials: ZS
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Guo
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yi
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Geng
authors.affiliation: Department of Pathology, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Li
authors.affiliation: Department of Central Laboratory, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266003, China.
authors.forename: Ru-Yong
authors.initials: RY
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000601:surgery / Q000821:virology; D018572:Disease-Free Survival; D015972:Gene Expression Regulation, Neoplastic; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D000509:alpha-Fetoproteins / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; D053539:Keratin-19; D000509:alpha-Fetoproteins