The Department of Surgery, Chang Gung Memorial Hospital, No 5 Fusing Street, Taoyuan County, Gueishan 333, Taiwan.
World J Surg Oncol. 2013 Jun 12;11(1):136. doi: 10.1186/1477-7819-11-136.
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).
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.
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.
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.
在原发性肝细胞癌（HCC）中 CK19 的表达与预后不良相关。然而，很少有研究调查过 CK19 在 HCC 肝切除术后区域淋巴结（LN）中的表达谱。本研究旨在评估 CK19 在伴或不伴淋巴结转移（LNM）的 HCC 原发肿瘤和区域 LN 中的表达。
采用免疫组织化学染色法检测 16 例伴 LNM 和 26 例不伴 LNM 的 HCC 患者的 CK19 表达。对原发肿瘤和 LN 标本均进行 CK19 表达研究。分析临床病理变量和预后意义。
原发肝脏肿瘤中 CK19 的免疫阳性与 LNM（P=0.005）和肿瘤无包膜（P<0.005）显著相关。单因素分析显示，原发肝脏肿瘤中 CK19 的表达、区域 LN 中 CK19 的表达、血管侵犯、子灶、阳性切缘和美国癌症联合委员会（AJCC）肿瘤分期均显著降低了总生存率。多因素分析表明，子灶（P=0.001）和区域 LN 中 CK19 的表达（P=0.002）是总生存率的独立预后因素。
本研究表明 HCC 区域 LN 中 CK19 的表达与 LNM 和术后极差的预后相关。识别这些高危 HCC 患者具有重要的临床意义，多模式治疗可能有助于改善其不良预后。
