Abstract
e14667 Background: The prognosis is unsatisfactory and can hardly be predicted for those patients with intrahepatic cholangiocarcinoma (ICC) underwent hepatectomy. The aim of this study is to investigate the prognostic values of glandular epithelia related cytokeratin 7 (CK7), cytokeratin 8 (CK8), cytokeratin 18 (CK18), and cytokeratin 19 (CK19) and their relations with clinicopathological characteristics in ICC patients. Methods: Tumor tissue microarrays (TMAs) of 162 ICC patients who underwent curative resection between 2001 and 2006 were used to detect the expressions of CK7, CK8, CK18 and CK19. The prognostic significance was assessed using Kaplan-Meier survival estimates and log-rank tests. Clinicopathologic data for these patients were evaluated. Results: The strong expression percentage for these four cytokeratins in 162 ICC patients was 79.0% (CK7), 51.2% (CK8), 76.5% (CK18), and 68.5% (CK19). The expression of CK7 was found to be associated with hepatitis B surface antigen (HBsAg) and alpha-fetoprotein (AFP) while CK19 was associated with HBsAg, carcinoembryonic antigen (CEA), gammaglutamyl transferase (GGT), carbohydrate antigen 19-9 (CA19-9) and tumor size. Tumor staging was linked with the expression of CK7, CK8 and CK18 except CK19. Both univariate and multivariate analyses revealed that CK18 and CK19 were significant predictors for overall survival (OS). CK19 strong expression and CK18 weak expression were correlated with poor prognosis regardless of tumor size, tumor encapsulation and perihila lymph node involvement. The OS rate in CK19strong and CK19weak patients were 16.2% and 39.2 % (P<0.005). The OS rate in CK18strong and CK18weak patients were 28.2% and 7.9% (P<0.001). CK19 combined with CK18 still related with OS. The OS rate in CK19strongCK18weak patients was 7.1%, which was significantly lower than that of CK19weakCK18strong patients (46.3%, P<0.001). Conclusions: CK18 and CK19 can be used as novel predictors for the prognosis of ICC.
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