| Objective:Hepatocellular carcinoma(HCC)is one of the most common malignant tumors in clinic.It has the characteristics of covert incidence and difficult to cure.It has become the third leading cause of cancer death in the world and the second highest in China.Vascular invasion of hepatocellular carcinoma mainly includes macrovascular invasion and microvascular invasion.Studies have shown that MVI is an important risk factor for postoperative disease-free survival and early recurrence in patients with liver cancer.The invasion of large vessels can often be evaluated by preoperative imaging examination,but MVI can not be judged by routine preoperative examination at present,and can only be diagnosed by postoperative histopathology.Therefore,the relationship between microvascular invasion and clinicopathological features of hepatocellular carcinoma was investigated.In order to improve the prognosis of patients with liver cancer,this paper provides the relevant basis for optimizing the operation mode and the comprehensive treatment of postoperative tumor,so as to solve the problem of high recurrence rate after radical resection of liver cancer.Methods:From June 2015 to April 2017,76 patients with hepatocellular carcinoma(HCC)were selected for surgical treatment in Qianfoshan Hospital affiliated to Shandong University.All tumor specimens were collected by standard pathology.According to the existence of microvascular invasion,they were divided into MVI group and no MVI group according to the status of microvascular invasion.To analyze the relationship between mvi and related clinicopathological features(sex,age,tumor diameter,tumor number,pathological grade,preoperative AFP,positive rate of ki67,number of intravascular cancer cells and invasion of bile duct).All clinicalpathological data were collected and analyzed by chi-square test and multiple logistic regression analysis.Univariate analysis was used to find out the correlation between the occurrence of mvi and clinicopathological features,and the difference was statistically significant(p<0.05).In order to find the clinicopathological features closely related to the occurrence of mvi,the statistical significance of the difference after univariate analysis was further analyzed in the multivariate regression equation of logistic.Results:A total of 76 patients after hepatectomy were included in this study,69 of whom were male(90.80%)and 7 were female(9.20%)with an average age of 55.8 ±3.5 years.Of 76 consecutive HCC patients,50(65.79%)were founded to have a micro vascular invasion.Tumor diameter(P<0.001),tumor pathological grade(P<0.001)were correlated with MVI.But there was no significant correlation between the incidence of MVI and sex(P=0.244),age(P=0.510),the number of tumors(P= 0.522),preoperative AFP(P=0.312),the positive rate of Ki67(P=0.551),the number of cancer cells suspended in the vessel(P=0.260)and the invasion of the bile duct(P=0.151).Logistic multivariate analysis showed that tumor diameter d>3cm and tumor pathological grade were independent risk factors for MVI.Conclusion:Tumor diameter and tumor pathological grade differentiation are independent risk factors for MVI.There was no significant correlation between the occurrence of mvi and sex,age,tumor number,the number of cancer cells in vascular suspension,and the invasion of bile duct.Significants:It is helpful to predict the probability of mvi and to provide some reference for surgical treatment(choice of operation mode,treatment of surgical margin,etc.)in patients with liver cancer by perfecting preoperative imaging examination to judge tumor diameter.Determinations of tumor diameter by imaging examination and tumor pathological grade by liver biopsy preoperratively will provide us a novel clinical strategy of the prediction of the occurrence of MVI,so as to provide clinical guidances for determining surgical methods and postoperative comprehensive treatment in HCC patients. |
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