Predictive Value Of Preoperative ¹⁸F-FDG PET/CT Related Parameter Risk Model For MVI Positivity And Early Postoperative Recurrence Of Hepatocellular Carcinoma

Introduction:This study aims to screen independent predictors of the presence of MVI based on preoperative ¹⁸F-FDG PET/CT metabolic characteristics of HCC patients and pre-treatment tumor markers,in order to provide clinicians with a preoperative prediction model for predicting the presence of MVI in HCC patients.Materials:The clinical data of 55 patients with hepatocellular carcinoma with BCLC stage A or B who were admitted to the Affiliated Cancer Hospital of Guangxi Medical Sciences on January 1,2018 and December 30,2020 were retrospectively analyzed.The independent sample t test,Mann-Whitney U test andχ²test were used to compare the differences of multiple factors between the two groups of patients.Multivariate Logistic regression was used to screen the independent influencing factors,and a risk prediction model and a histogram were constructed.Receiver operating characteristic（ROC）curve was used to evaluate the diagnostic performance of the predictive model.Kaplan-Meier method was used to compare the incidence of early recurrence between MVI postive group and the MVI negative group.Results:Univariate analysis showed that the tumor diameter of the MVI postive group was larger than that of the MVI negative group（10.76cm±3.67cm vs 6.28cm±2.86cm）,the TLR of the MVI postive group was higher than that of the MVI negative group（3.21±1.19 vs1.90±0.82）,and the AFP level of the MVI group was higher than that of the non-MVI group（495.05ng/ml±767.04 ng/ml vs.74.32ng/ml±137.79ng/ml）,with statistical significance between the two groups（P<0.05）.Multiple logistic regression analysis indicated that TLR and tumor diameter before treatment were independent risk factors for predicting the existence of MVI（P<0.05）.The tumor diameter and TLR were used to establish the risk prediction model.The area under the curve of the prediction model was evaluated by ROC curve with AUC=0.71,specificity 91%and sensitivity50%.Kaplan-Meier survival analysis showed that the early recurrence rate of MVI postive group was higher than that of the MVI negative group.The postoperative recurrence rates of the MVI group and the MVI negative group at3,6,12 and 2 months were 9.09%,45.50%,86.00%,and 86.00%,vs 6.06%,18.52%,33.93%,and 44.43%,respectively（P=0.004）.Conclusion:The ¹⁸F-FDG PET/CT metabolic characteristic parameter risk model has great clinical application value in predicting MVI in HCC patients.The MVI postive group was significantly associated with early recurrence in HCC patients undergoing radical surgery.