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Prognostic implications of tumor vascularity and its relationship to cytokeratin 19 expression in patients with hepatocellular carcinoma

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Abstract

Objective

Although hepatocellular carcinoma (HCC) demonstrates characteristic hypervascularity, some HCCs have a hypovascular pattern on computed tomography (CT). Cytokeratin 19 (CK19) is a marker for the biliary phenotype reflecting a poor prognosis. We assessed the prognostic implications of tumor vascularity and its association with CK19 expression in HCC.

Methods

Patients that underwent surgical resection for HCC were included. Tumor vascularity was evaluated according to the arterial enhancement patterns on CT scans and CK19 expression was evaluated by using tissue microarray methods.

Results

One hundred and forty patients were included. Their median follow-up duration was 55.0 months, and 92 (65.7%) patients had tumor recurrence. Forty-five patients (30.6%) had hypovascular HCC at the time of diagnosis, and they showed a significantly higher CK19 expression rate (32.5% vs. 8.2%, P = 0.001) and earlier recurrence rate within 6 months (hazard ratio (HR), 2.301; P = 0.025) compared to the patients with hypervascular HCCs. Hypovascularity (HR, 1.694; P = 0.045) was an independent risk factor for short overall survival.

Conclusions

Hypovascular HCCs were associated with early recurrence and short overall survival, and CK19 was more frequently expressed in hypovascular HCC than in hypervascular tumors. Therefore, tumor vascularity on CT images might be utilized in determining the prognosis of patients with HCCs.

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Acknowledgements

This study was supported by the Korean Foundation of Liver Research (2009) and the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Internal Medicine, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, South Korea

    Goh Eun Chung

  2. Department of Internal Medicine, Seoul National University Hospital, 28 Yungun-dong Chongno-gu, Seoul, 110-744, South Korea

    Jeong-Hoon Lee, Jung-Hwan Yoon, Sun Jung Myung, Yoon Jun Kim & Hyo-Suk Lee

  3. Department of Pathology, Seoul National University Hospital, Seoul, South Korea

    Kyoungbun Lee & Ja June Jang

  4. Department of Radiology, Seoul National University Hospital, Seoul, South Korea

    Jeong Min Lee & Se-Hyung Kim

  5. Department of Surgery, Seoul National University Hospital, Seoul, South Korea

    Kyung-Suk Suh

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  1. Goh Eun Chung
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Correspondence to Jung-Hwan Yoon.

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Chung, G.E., Lee, JH., Yoon, JH. et al. Prognostic implications of tumor vascularity and its relationship to cytokeratin 19 expression in patients with hepatocellular carcinoma. Abdom Imaging 37, 439–446 (2012). https://doi.org/10.1007/s00261-011-9756-3

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