Effects Of Cytokeratin 19 And Microvascular Invasion On The Prognosis Of Hepatocellular Carcinoma

Objective: Aim To evaluate the effect of cytokeratin 19(CK19)and microvascular infiltration(MVI)on the prognosis of hepatocellular carcinoma(HCC).Methods: Methods Clinicopathological data of 352 patients with HCC after resection from January 2013 to December 2015 were retrospectively analyzed.According to CK19 and MVI,they were divided into four groups:CK19(-)/ MVI(-),CK19(-)/ MVI(+),CK19(+)/ MVI(-),and CK19(+)/MVI(+).The effects of CK19 and MVI on the prognosis of HCC were explored by the Kaplan-Meier method and the Cox-proportional hazards model.Results: Results Of 352 HCCs,154 were CK19(-)/ MVI(-)(43.8%),116 were CK19(-)/ MVI(+)(33.0%),31 were CK19(+)/ MVI(-)(8.8%),51 were CK19(+)/ MVI(+)(14.4%).The tumor-free survival(DFS)of CK19(-)/ MVI(-)HCC was higher than the DFS of CK19(-)/ MVI(+)HCC and CK19(+)/ MVI(+)HCC(P values were 0.044,0.002,respectively).There is no statistical difference between any other two groups.The overall survival(OS)of CK19(-)/ MVI(-)HCC is higher than the OS of CK19(-)/ MVI(+)HCC and CK19(+)/ MVI(+)HCC(P = 0.020,P ﹤0.001,respectively),while the OS of CK19(+)/ MVI(+)HCC are significantly lower than the OS of CK19(-)/ MVI(-)HCC,CK19(+)/MVI(-)HCC and CK19(-)/ MVI(+)HCC(P ﹤0.001,P = 0.010,P = 0.031,respectively).Univariable analysis revealed that CK19 expression and MVI were risk factors for DFS and OS.Multivariable analysis indicated that CK19 is an independent risk factor for DFS and MVI is an independent risk factor for OS.Conclusions: Conclusion Both CK19 expression and MVI prompt for a poor prognosis,which have an additive effect on the adverse effects of HCC on overall survival.HCC expressing CK19 with MVI has the worst prognosis.Combined with CK19 and MVI to evaluate the prognosis of HCC can better play the predicted value.