角蛋白 19 的表达与射频消融后肝细胞癌的高复发率相关。

Expression of keratin 19 is related to high recurrence of hepatocellular carcinoma after radiofrequency ablation.

机构信息

Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.

出版信息

Oncology. 2011;80(3-4):278-88. doi: 10.1159/000328448. Epub 2011 Jul 7.

DOI:10.1159/000328448

PMID:21734420

Abstract

OBJECTIVE

Keratin (K) 19 positivity has been reported to be a useful predictive marker for recurrence in patients with hepatocellular carcinoma (HCC) who have undergone hepatic resection. We investigated the clinical usefulness of K19 positivity in patients who had received curative radiofrequency ablation (RFA).

METHODS

We retrospectively evaluated the clinicopathological features, including imaging and K19 expression, in 246 patients with HCC who were within the Milan criteria and had received curative RFA. Using a two-step insertion method, tumor biopsies were obtained just prior to RFA and were evaluated histologically.

RESULTS

Tumor seeding due to liver biopsy and RFA was not observed. Ten patients (4.1%) had K19-positive HCC. Imaging findings were similar between K19-positive and -negative HCC (p = 0.187). Nine out of 10 patients (90%) who had K19-positive HCC had recurrence of HCC after RFA, and intrahepatic recurrences were observed within 12 months in 6 out of 10 (60.0%). K19 positivity was a significant risk factor for recurrence (p < 0.0001) and early recurrence (<1 year after RFA; p =0.012). K19 expression (p = 0.016) was an independent risk factor for tumor status exceeding the Milan criteria after RFA.

CONCLUSION

Expression of K19 is related to high recurrence of HCC after curative RFA.

摘要

目的

已有报道称，角蛋白（K）19 阳性是接受肝切除术的肝细胞癌（HCC）患者复发的有用预测标志物。我们研究了 K19 阳性在接受根治性射频消融（RFA）治疗的患者中的临床应用价值。

方法

我们回顾性评估了 246 例符合米兰标准且接受根治性 RFA 的 HCC 患者的临床病理特征，包括影像学和 K19 表达。采用两步插入法，在 RFA 前获取肿瘤活检，并进行组织学评估。

结果

未观察到因肝活检和 RFA 导致的肿瘤播散。10 例（4.1%）患者 HCC 为 K19 阳性。K19 阳性和阴性 HCC 的影像学表现相似（p = 0.187）。10 例 K19 阳性 HCC 患者中有 9 例（90%）在 RFA 后 HCC 复发，其中 6 例（60.0%）在 10 例中观察到肝内复发。K19 阳性是复发的显著危险因素（p < 0.0001）和早期复发（RFA 后<1 年；p =0.012）。K19 表达（p = 0.016）是 RFA 后肿瘤状态超过米兰标准的独立危险因素。