Effect Of CK19 And Ki-67 Expression On Prognosis Of Postoperative Patients With Hepatocellular Carcinoma

Primary liver cancer is a major malignant tumor harmful to people’s health,At present,surgical resection,liver transplantation,interventional chemotherapy(TACE),radiofrequency ablation of(RFA)and immunotherapy are the main factors to improve the prognosis of patients.Even after radical surgery,70% of patients still relapse within5 years.High recurrence rate and case fatality rate are the biggest problems we are facing at present.In recent years,attention has been paid to the biological role of the expression of CKl9 in HCC in the occurrence and development of HCC.It has been found that the expression and increase of CK19 in human hepatocellular carcinoma cell lines indicate that hepatocellular carcinoma cells have higher metastatic ability.After inoculating highly metastatic hepatoma cells in nude mice,it was found that the expression level of CK19 increased significantly during tumor metastasis,suggesting that the progression of hepatocellular carcinoma may be related to CK19.In the study of serum CK19 and clinicopathological data,it was found that the increase of serum CKl9 was related to HCC differentiation,vascular invasiveness and clinical stage.CK19 is called a biliary marker and is not expressed in mature hepatocytes.In animal experiments,partial hepatectomy was used to stimulate the proliferation of oval cells.It was found that oval cells expressed not only bile duct cell markers such as CK19,but also hepatocyte markers.Some studies have shown that oval cells proliferate and eventually produce hepatoma cells in mice,It is suggested that CK19 positive HCC may be a special "subtype" formed by abnormal proliferation and differentiation of oval cells.Ki-67 is a kind of cell proliferating nuclear antigen and is an effective index to evaluate cell proliferation.The higher the positive rate of Ki-67,the higher the proportion of cells in the proliferation cycle and the faster the tumor growth.At present,Ki-67 level is widely used in the evaluation of breast cancer,lung cancer and other tumors.Some studies have shown that Ki-67 has a certain regulatory effect on stem cells,and there are differences in the expression level of Ki-67 in different tissue differentiation and progression of liver cancer.Purpose:1.To understand the expression of CKl9 and Ki-67 in HCC tumor tissues;2.To study the relationship between the expression of CKl9,Ki-67 and clinicopathological features and prognosis.Research methods: The patients who underwent hepatectomy for the first time in the Department of Hepatobiliary surgery,affiliated Cancer Hospital of Guangxi Medical University from February 1,2012 to December 30,2017 were collected.The general clinical data of 343 cases were collected according to the inclusion criteria and exclusion criteria,including age,sex,serum HBs Ag,preoperative serum AFP level,liver cirrhosis,tumor size,portal vein tumor thrombus(with or without),tumor number(single or multiple),tumor capsule(intact or incomplete),Edmondson-Steinergrade,CK19,Ki-67 immunohistochemist ry,early recurrence time,tumor-free survival time and total survival time.The continuous variables of non-normal distribution were converted into binary variables by median.The differences of CK19 and Ki-67 expression among different stratification were analyzed by chi-square test.Kaplan-Meier survival curve was used to analyze and compare the early recurrence,tumor-free survival time and total survival time.The independent risk factors of recurrence and death were analyzed by multivariate Cox risk model.Results: The high expression of Ki-67 is related to early recurrence and tumor-free survival time.The positive expression of CK19 was related to the early recurrence and the total survival time of the patients.The prognosis of patients with high expression of CK19 /Ki-67 in hepatocellular carcinoma was worse.Portal vein tumor thrombus,tumor number,tumor size,tumor capsule,degree of differentiation and Ki-67 expression are the risk factors affecting the total survival time of patients.Portal vein tumor thrombus,tumor size,differentiation and Ki-67 expression are the risk factors for tumor-free survival.Conclusion:(1)The expression of CK19 and Ki-67 is related to the prognosis of patients with hepatocellular carcinoma;(2)The high expression of CK19/Ki-67 can be used as an important biomarker to judge the malignant degree and clinical prognosis of hepatocellular carcinoma.