Objective To investigate the value of Gd-EOB-DTPA enhanced MRI in predicting the expression of cytok-eratin 19(CK19)in hepatocellular carcinoma(HCC),and to evaluate the prognosis of patients with CK19 positive HCC and patients with CK19 negative HCC after radical resection.Methods MRI and clinicopathological data of HCC patients undergoing hepatectomy were analyzed retrospectively.To evaluate the correlation between MRI qualitative、quantitative in-dicator,clinicopathological characteristics and CK19 positive expression.Multivariate logistic regression was used to identify independent predictors of CK19 positive HCC.The predictive efficacy of CK19 expression was evaluated by analyzing the working characteristic curve of subjects.Kaplan-Meier method was used to evaluate relapse free survival.Results Totally 137 patients were included(105 in CK19 negative group and 32 in CK19 positive group).CK19 positive HCC was correla-ted with arterial rim enhancement,tumor-to-liver signal intensity ratio(SR)on hepatobiliary phase,DWI or HBP target sign and alpha fetoprotein(AFP)(P<0.05).Multivariate analysis showed arterial rim enhancement and AFP>400 IU/ml were independent predictors of CK19 positive HCC.The area under the curve of CK19 positive HCC predicted by combi-ning the above two indicators was 0.750,the sensitivity was 72.4% ,and the specificity was 75.9% .Compared with CK19 negative HCC patients,the recurrence free survival(RFS)of CK19 positive HCC patients after hepatectomy was lower(65.5% vs81.4% at 1 year,51.0% vs 65.9% at two years),but there was no significant difference between the two groups(log-rank P =0.164).Conclusion arterial rim enhancement and AFP level in arterial phase are helpful to pre-dict CK19 positive HCC before operation,and CK19 positive HCC is more likely to early recurrence(<2 years)after radi-cal resection.
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