Investigation Clinical Features Of CK19 Positive Hepatocellular Carcinoma Recurrence After Surgery And The Changes Expression Of Intermediate Filaments Gene

Objective:Part of hepatocellular carcinoma(HCC)express CK19,indicating malignant biological behavior such as invasion,metastasis and worse prognosis.Some reports suggesting that HCC has non-fetoprotein tumor markers ascended on serum level before surgery,such as CA199,CA125,etc.But the clinical and pathological significance of CK19 positive HCC and ascended tumor markers level is still unknown.For this reason,this study investigate the clinical features of CK19 positive HCC and the level of tumor markers.Methods : Retrospectively selected 536 patients had been pathologically diagnosed HCC in our hospital from January 2015 to December 2016.Serum tumor marker levels(AFP,CEA,CA125,CA153,CA199,CA724)were measured before surgery,and CK19 was performed after Immunohistochemical detection.Intermediate silk expression characteristic specimens were selected from CK19 +HCC tissues(positive group),CK19-HCC tissues(negative group),and liver focal nodular hyperplasia(FNH)tissue(control group).The intermediate filament observation indicators choose FLG,LMNA,LMNB and LMNC genes.Results:The basic clinical situation of the selected patients: 1、Included 536 HCC patients,291 with recurrenced(55.3%)and 245 were not recurrenced(45.7%).There were 115 cases(21.5%)in the CK19+ group and 421 cases(78.5%)in the CK19-group.There was no statistical difference in the sex composition ratio,hepatitis B infection ratio,ascites,and liver function between the two groups;age,recurrence,BCLC stage,Edmondson classification Statistical differences.Tumor markers,AFP level and CA199 level in CK19+group were higher than those in CK19-group.2.The relationship between CK19+ and the risk of postoperative recurrence:The results of COX analysis showed that the postoperative recurrence of CK19+ patients was related to age,BCLC stage,Edmondson classification,the presence of cancer thrombus,AFP positive and CA199 positive;There is no risk relationship with gender,MVI,CEA positive,CA125 positive,CA153 positive,CA724 positive,TBIL,DBIL,ALT,AST,ALG,PA,ascites and hepatitis B infection.CK19-positive patients,the risk relationship with various observation indicators are: age,Edmondson classification,AFP positive and CA199 positive.3.The relationship between recurrence and CK19+ after surgical radical resection of HCC: kplan Meier survival analysis showed that the RFS of CK19+ group was shorter than that of CK19-,and the RFS was 1.34 times lower than that of CK19-group,suggesting that patients with CK19-group had earlier relapse Further stratification of years of recurrence supports the same result.Risk analysis suggests that CK19 is a separate risk factor,and patients with CK19+ HCC patients,the risk relationship with various observation indicators are: age,Edmondson classification,AFP positive and CA199 positive.Among them,the age is 0.95 time(negative correlation,the patient’s age is very low,the risk is greater),Edmondson classification is 1.6 times,AFP is 2.7 times positive,and CA199 is 6.2 times positive.3.The relationship between recurrence and CK19+ after surgical radical resection of HCC: kplan Meier survival analysis showed that the RFS of CK19+ group was shorter than that of CK19-,and the RFS was 1.34 times lower than that of CK19-group,suggesting that patients with CK19-group had earlier relapse Further stratification of years of recurrence supports the same result.Risk analysis suggests that CK19 is a separate risk factor,and patients with CK19+HCC may have a worse prognosis.4.The expression characteristics of intermediate filament gene in CK19+ group:(1)FLG gene: the relative expression of CK19+ group is higher than that of negative group(P <0.01),and also higher than that of control group(P <0.01).(2)LMNA gene: The relative expression level of CK19+ group was higher than that of negative group(P<0.01),and also higher than that of control group(P <0.01).(3)LMNB gene:The relative expression level of CK19+ group was higher than that of negative group(P <0.01),and also higher than that of control group(P <0.01).(4)FLNC gene: the relative expression level of CK19 +group was lower than that of CK19-group(P <0.01),also lower than that of control group(P <0.01),and CK19-group was lower than that of control group(P <0.05).Among the four intermediate filament genes observed in the CK19+ group,FLG,LMNA and LMNB showed high expression and LMNC showed low expression.Conclusions:From the data of this group,patients with CK19 + HCC cancer have a high recurrence rate after surgical radical resection and a short period of cancer-free survival.The age of onset and recurrence of liver cancer patients in the CK19 + group is relatively low,which is related to the BCLC stage and Edmondson classification.It may be because CK19 + HCC has CCA-like performance,has stronger value-added and invasiveness,poor differentiation,and metastasis Sex is stronger.The RFS of CK19 + group was shorter than that of CK19-group,and the RFS was 1.34 times lower than that of CK19-group.CK19 was a single risk factor;the results showed that the RFS of patients in CK19+/CA199+both positive subgroup was lower than that in CK19/CA199single-positive subgroup,and also lower than that in CK19/CA199 both negative subgroup.The CK19+ HCC subgroup has some clinical characteristics similar to biliary and pancreatic malignant tumors,which may come from the proliferation and differentiation ability of progenitor cells from the original liver.The relationship between CK19+ HCC intermediate filament genes is complex.Exploring the mechanism of CK19+ HCC intermediate filament gene mutations is helpful to understand the regulatory role of CK19+ in HCC.