Abstract
Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings.
Highlights
As the fifth most common malignancy and the third leading cause of malignancyrelated mortality, the incidence of hepatocellular carcinoma (HCC) is still on the rise [1,2]
CYFRA 21-1 appears to be a sensitive biomarker for cytokeratin 19 (CK19) expression in HCCs with a predictive power of 0.81 [11,12], routine laboratory test of preoperative serum CYFRA 21-1 may be limited, as CK19 expression is only present in approximately 10–30% of HCC patients
Lymphocytes are involved in cell-mediated anti-tumor immune responses [16] and neutrophil to lymphocyte ratio (NLR) has been found to be independently associated with survival in HCC patients [17]
Summary
As the fifth most common malignancy and the third leading cause of malignancyrelated mortality, the incidence of hepatocellular carcinoma (HCC) is still on the rise [1,2]. CYFRA 21-1, a soluble fragment of CK19, has been detected in peripheral circulation in various malignancies including HCCs [8,9,10,11]. Neutrophil to lymphocyte ratio (NLR) has been widely studied for post-therapeutic recurrence and survival in HCC [13,14,15]. Lymphocytes are involved in cell-mediated anti-tumor immune responses [16] and NLR has been found to be independently associated with survival in HCC patients [17]. The aims of the study were to examine the relationship between NLR and CK19 expression in HCCs and to develop a panel of biomarkers in the prediction of CK19 expression
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
