Abstract：
OBJECTIVE: Cytokeratin 19 fragment 21-1 (CYFRA 21-1) and cytokeratin 19 fragment 2G2 (CK 19-2G2) are two soluble fragments of cytokeratin 19 (CK 19) that can be detected in serum. CK 19-positive hepatocellular carcinoma (HCC) is characterized by an aggressive behavior and a poor outcome. This study aimed to assess the prognostic value of serum CYFRA 21-1 and CK 19-2G2 in predicting tumor aggressiveness and overall survival (OS) in patients with hepatic C virus (HCV)-related HCC.
METHODS: The current study included 138 patients with HCV-related HCC recruited from the Hepatobiliary and Interventional Radiology Units at Alexandria\'s main university hospitals and 40 healthy individuals as controls. Patients were assessed for clinical, radiological tumor characteristics, and aggressiveness index. Baseline serum CYFRA 21-1 and CK 19-2G2 levels were measured by enzyme-linked immunosorbent assay.
RESULTS: Elevated CYFRA 21-1 levels were associated with tumors size ≥ 5 cm (p < 0.001), malignant portal vein thrombosis (mPVT) (p < 0.001), distant metastasis (p = 0.030), ill-defined/infiltrative pattern (p = 0.010), and aggressiveness index > 4 (p = 0.045). Elevated CK19-2G2 levels were not associated with any clinical or radiological characteristics. Either or both elevated serum CYFRA 21-1 and CK 19-2G2 in combination with alpha-feto protein (AFP) ≥ 400 ng/ml have a better predictability for mPVT and ill-defined/infiltrative patterns (sensitivity (10-25%) and specificity (96-100%)). Elevated levels of CYFRA 21-1, CK 19-2G2, or AFP ≥ 400 ng/ml were associated with decreased 1-year OS.
CONCLUSIONS: Either or both elevated serum CYFRA 21-1 and CK 19-2G2 levels when added to AFP ≥ 400 ng/ml are specific but less sensitive biomarkers for predicting tumor aggressiveness. These biomarkers can be used independently to predict reduced 1-year OS in Egyptian patients with HCV-related HCC.
METHODS: The current study included 138 patients with HCV-related HCC recruited from the Hepatobiliary and Interventional Radiology Units at Alexandria\'s main university hospitals and 40 healthy individuals as controls. Patients were assessed for clinical, radiological tumor characteristics, and aggressiveness index. Baseline serum CYFRA 21-1 and CK 19-2G2 levels were measured by enzyme-linked immunosorbent assay.
RESULTS: Elevated CYFRA 21-1 levels were associated with tumors size ≥ 5 cm (p < 0.001), malignant portal vein thrombosis (mPVT) (p < 0.001), distant metastasis (p = 0.030), ill-defined/infiltrative pattern (p = 0.010), and aggressiveness index > 4 (p = 0.045). Elevated CK19-2G2 levels were not associated with any clinical or radiological characteristics. Either or both elevated serum CYFRA 21-1 and CK 19-2G2 in combination with alpha-feto protein (AFP) ≥ 400 ng/ml have a better predictability for mPVT and ill-defined/infiltrative patterns (sensitivity (10-25%) and specificity (96-100%)). Elevated levels of CYFRA 21-1, CK 19-2G2, or AFP ≥ 400 ng/ml were associated with decreased 1-year OS.
CONCLUSIONS: Either or both elevated serum CYFRA 21-1 and CK 19-2G2 levels when added to AFP ≥ 400 ng/ml are specific but less sensitive biomarkers for predicting tumor aggressiveness. These biomarkers can be used independently to predict reduced 1-year OS in Egyptian patients with HCV-related HCC.
摘要：
目的：细胞角蛋白19片段21-1（CYFRA21-1）和细胞角蛋白19片段2G2（CK19-2G2）是两种可在血清中检测到的细胞角蛋白19（CK19）的可溶性片段。CK19阳性肝细胞癌（HCC）的特征是攻击行为和不良预后。本研究旨在评估血清CYFRA21-1和CK19-2G2在预测肝C病毒（HCV）相关HCC患者的肿瘤侵袭性和总生存期（OS）中的预后价值。
方法：当前的研究包括从亚历山大大学主要医院的肝胆和介入放射科招募的138名HCV相关HCC患者和40名健康个体作为对照。对患者进行临床评估，放射学肿瘤特征，和侵略性指数。采用酶联免疫吸附法检测血清CYFRA21-1和CK19-2G2水平。
结果：CYFRA21-1水平升高与肿瘤大小≥5cm相关（p<0.001），恶性门静脉血栓形成（mPVT）（p<0.001），远处转移（p=0.030），不明确/渗透模式(p=0.010)，攻击性指数>4(p=0.045)。CK19-2G2水平升高与任何临床或放射学特征无关。升高的血清CYFRA21-1和CK19-2G2中的任一者或两者与α-feto蛋白（AFP）≥400ng/ml的组合对mPVT和不明确/浸润模式具有更好的可预测性（敏感性（10-25％）和特异性（96-100％））。CYFRA21-1，CK19-2G2或AFP≥400ng/ml的水平升高与1年OS降低相关。
结论：当添加到AFP≥400ng/ml时，血清CYFRA21-1和CK19-2G2水平升高之一或两者都是预测肿瘤侵袭性的特异性但敏感性较低的生物标志物。这些生物标志物可独立用于预测埃及HCV相关HCC患者1年OS降低。
方法：当前的研究包括从亚历山大大学主要医院的肝胆和介入放射科招募的138名HCV相关HCC患者和40名健康个体作为对照。对患者进行临床评估，放射学肿瘤特征，和侵略性指数。采用酶联免疫吸附法检测血清CYFRA21-1和CK19-2G2水平。
结果：CYFRA21-1水平升高与肿瘤大小≥5cm相关（p<0.001），恶性门静脉血栓形成（mPVT）（p<0.001），远处转移（p=0.030），不明确/渗透模式(p=0.010)，攻击性指数>4(p=0.045)。CK19-2G2水平升高与任何临床或放射学特征无关。升高的血清CYFRA21-1和CK19-2G2中的任一者或两者与α-feto蛋白（AFP）≥400ng/ml的组合对mPVT和不明确/浸润模式具有更好的可预测性（敏感性（10-25％）和特异性（96-100％））。CYFRA21-1，CK19-2G2或AFP≥400ng/ml的水平升高与1年OS降低相关。
结论：当添加到AFP≥400ng/ml时，血清CYFRA21-1和CK19-2G2水平升高之一或两者都是预测肿瘤侵袭性的特异性但敏感性较低的生物标志物。这些生物标志物可独立用于预测埃及HCV相关HCC患者1年OS降低。
