Prognostic value of cytokeratin 19 in hepatocellular carcinoma: A meta-analysis

Background: Although many studies have investigated the relationship between cytokeratin 19 (CK-19) and hepatocellular carcinoma (HCC), the prognostic value of CK-19 in HCC remains inconclusive.

Methods: Eligible studies were sought in PubMed, Embase, Web of Science, Cochrane Library and Wanfang databases. Pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated.

Results: 17 studies with 2943 patients were included in this meta-analysis. Meta-analysis results showed that CK-19 over-expression was significantly associated with overall survival (OS) (HR=1.60, 95% CI: 1.32-1.93, univariate analysis; HR=2.25, 95% CI: 1.79-2.83, multivariate analysis) and disease-free survival (DFS) (HR=1.68, 95% CI: 1.35-2.10, univariate analysis; HR=1.97, 95% CI: 1.54-2.53, multivariate analysis). Meanwhile, CK-19 over-expression was also correlated with decreased 1-year OS rate (OR=0.32, 95% CI: 0.21-0.50), 5-year OS rate (OR=0.44, 95% CI: 0.14-0.87) and 1-year DFS rate (OR=0.51, 95% CI: 0.34-0.76), but not with 5-year DFS rate (OR=0.62, 95% CI: 0.35-1.10). These results suggested that CK-19 over-expression was significantly associated with poor survival rate and early tumor recurrence rate in HCC patients.

Conclusions: CK-19 can serve as an indicator of poor prognosis as well as a novel target for treatment in HCC.