Histologic Classification Of Microvascular Invasion In Different Kind Of Primary Liver Cancer And The Assessment Of Them To Predict Prognosis

Prognostic value of a novel risk classification of microvascular invasion in patients with hepatocellular carcinoma after resectionObjectives:The present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion(MVI)in hepatocellular carcinoma(HCC)after resectionMethods:A total of 295 consecutive HCC patients underwent hepatectomy were included in our study from January 2004 to December 2013.We retrospectively examined the general information,clinical characteristics and histopathological characteristics of all these patients.And we evaluated the degree of MVI according to the following three features:the number of invaded microvessels(≤5 vs>5),the number of invading carcinoma cells(≤50 vs>50),the distance of invasion from tumor edge(≤1 cm vs>1 cm).Results:All patients were divided into three groups according to the three risk factors of MVI:non-MVI group(n=180),low-MVI group(n=60)and high-MVI group(n=55).The overall survival(OS)and recurrence-free survival(RFS)rates of high-MVI group were significantly poorer than those of low-MVI and non-MVI groups(P<0.001 and P=0.001;P<0.001 and P=0.003).Multivariate analysis showed high-MVI,type of resection and tumor size were risk factors for OS after hepatectomy.High-MVI,type of resection and tumor size were risk factors for RFS.In subgroup analyses,the OS and RFS rates of low-MVI and non-MVI groups were better than high-MVI group regardless of tumor size.In high-MVI group,anatomical liver resection(n=28)showed better OS and RFS rates compared with non-anatomical liver resection(n=29)(P=0.012 and P=0.002).Conclusions:The novel risk classification of MVI based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy.Prognostic value of a risk classification of microvascular invasion in patients with intrahepatic cholangiocarcinoma after resection and the comparison with microvascular invasion in hepatocellular carcinomaObjectives:Microvascular invasion(MVI)is also one of the most significant prognostic factors of intrahepatic cholangiocarcinoma(ICC).However,there hasn’t been any literature that had mentioned the histologic classification of microvascular invasion in intrahepatic cholangiocarcinoma.We evaluated the significance of MVI classification in this study,analyzed the prognosis based on MVI classification and made a comparison of the MVI in hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma.Methods:We herein enrolled 108 patients who were diagnosed with ICC and then underwent surgical exploration from February 2005 to August 2015 at our hospital.We examined them with microvascular invasion(n=43)for four features:the number of invaded microvascular,the maximum number of invading carcinoma cells,the farthest distance from the tumor,and vessel with muscular wall.Thus,Patients were classified into low MVI and High MVI groups according to them.Results:Of the total 108 patients,65 patients told no detectable MVI,whereas 30(27.8%)had low MVI,and 13(12.0%)had high MVI.The median follow-up period lasted 15 months.In the analysis of overall survival,high MVI group showed significantly less positive outcomes than the patients without MVI and the low MVI group,and so did the low MVI group and the patients without MVI.Multivariate analysis including revealed that TNM stage,resection margin,low-MVI,and high-MVI were independent factors for overall survival(P=0.001,P=0.009,P=0.036,P<0.001,respectively).For disease-free survival,TNM stage and Liver cirrhosis were independent factors for disease-free survival(P=0.001,P=0.030,respectively).In the comparison of the MVI in HCC and ICC,we found no significant difference in the incidence rate and the histopathological characteristics.However,the high-MVI in ICC patients could only predict poorer overall survival,and the high-MVI in HCC patients could predict poorer overall survival and disease-free survival at the same time.Conclusions:We arrived at forward a novel histologic evaluation of ICC which can preferably predict the risk of survival of patients with MVI after curative resection.And there was no significant difference in the incidence rate and the histopathological characteristics.