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% Cl: 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% Cl: 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. (C) 2015 Elsevier B.V. All rights reserved.