Correlation Between Micro-Vascular Invasion Of HCC With Preoperative CT Findings And Early Recurrence After Curative Resection Of Hepatocellular Carcinoma

Objective: To investigate the correlation between Micro-vascular Invasion of HCC with preoperative CT findings and early postoperative recurrence,Analyze the independent risk factors of MVI and provide imaging basis for preoperative prediction of MVI.Methods: A retrospective analysis of preoperative CT imaging of 232 patients with HCC who perform surgery and confirmed by pathology in First Affiliated Hospital of Guangxi Medical University from January 2014 to December 2015.There are 203 males and 29 females,aged 22 to 79 years old,and average age is 48 years old.Postoperative pathology find that there are90 MVI patients,including 67 low-risk MVI patients(M1)and 23 high-risk patients(M2),and 90 patients did not be found the Micro-vascular Invasion.A total of 116 patients who were found relapsed after surgerying 2 years.There were 116 patients who were not found relapsed.The tumor-free survival timewas 3 to 23 months.Analysising the correlation between preoperative CT findings with MVI,correlation between tumor differentiation with MVI,and correlation between MVI with recurrence after surgerying 2 years by univariate and multivariate analyses.Drawing the ROC curve to evaluate the diagnostic value of tumor diameter for MVI.Results: Univariate analysis showed that the maximum transverse diameter,tumor density,marginal morphology,borderline,and pseudocapsule integrity of the tumor were significantly different from the risk of MVI.The patients of MVI have larger maximal diameter,less uniform density,irregular edges,blurred boundary,and less complete pseudocapsules than those without MVI.The comparison each other showed that there is no significant difference in the above-mentioned CT performance between high-risk group of MVI and low-risk group of MVI.The degree of tumor differentiation was closely related to MVI(P<0.01).The lower the degree of tumor differentiation,the greater the risk of MVI development.The difference between the risk of tumor MVI and recurrence after 2 years of surgery was statistically significant,the higher the risk of MVI,the higher the recurrence rate and the earlier the recurrence of the tumor after 2years of surgery.Multivariate analysis showed that the tumor boundary,the maximum diameter of the tumor,and the integrity of the pseudocapsule were independent risk factors for MVI;the larger the transverse diameter of the tumor,the more blurred the boundary and the less complete the pseudocapsule,the greater the risk of MVI development.According to the diameter of the tumor,the ROC curve shows that when the tumor’s maximum diameter is greater than or equal to 3.65 cm,the risk of developing MVI increases(the sensitivity is0.862 and the specificity is 0.56).Conclusion: The tumor boundary,the maximum diameter of the tumor,andthe integrity of the pseudocapsule were independent risk factors for MVI;the larger the transverse diameter of the tumor,the more blurred the boundary and the less complete the pseudocapsule,the greater the risk of MVI development.When the maximum diameter of the tumor is greater than or equal to 3.65 cm,the risk of MVI increases.The lower the degree of tumor differentiation,it is more likely that MVI occurs.The higher the risk of MVI,the higher the recurrence rate of the tumor after 2 years of surgery and the earlier the recurrence time.