Risk Factors Of Microvascular Invasion In Hepatocellular Carcinoma

Objectives:Hepatocellular carcinoma(HCC)is one of the most common malignant tumors in the world.Significant progress has been made in the treatment of HCC.Liver resection(LR)and liver transplantation(LT)are still the most effective methods for the treatment of HCC.However,the incidence of recurrence and metastasis after operation are high,which seriously affect the prognosis of patients.Many studies have found that microvascular invasion(MVI)is one of the important factor influencing the prognostic evaluation of HCC after radical resection,and the presence of MVI shortens the recurrence time after operation.But MVI can only be diagnosed by pathology of the specimen after operation at present.Preoperative predictive MVI is of great significance to the clinical treatment decision.Therefore,this study analyzed the related factors of MVI in HCC to find the risk factors for MVI,and further discussed the risk factors of MVI,in order to predict the existence of MVI before operation.And it will play a guiding role in the treatment of HCC.Methods:We collected the general clinical data,examinations and pathology data of all HCC patients meeting the screening criteria from January 2016 to December 2017 in the Second Affiliated Hospital of Kunming Medical University.According to the pathological diagnosis of postoperative specimens,the patients were divided into MVI group and no MVI group.We retrospectively analyzed patients' general clinical data(gender,age,body mass index(BMI),history of hepatitis B(HBsAg)),liver function indexes(albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),Child-Pugh classification),other serological indexes(alpha-fetoprotein(AFP),HBV DNA quantification,platelet(PLT),prothrombin time(PT),fibrinogen(FIB)),imaging data(tumor diameter,number of tumors,tumor margin,tumor shape,tumor necrosis,macrovascular invasion,liver cirrhosis),and the histopathological grading to explore the correlation with the MVI.SPSS 19.0 statistical software was used to analyze the collected data,and p<0.05 was considered to be statistically differences.Firstly,single factor analysis was performed.Measurement data were compared using t test.Count data were compared using ?2 test.Finally,variables with statistical differences in the result of single factor analysis were further analyzed by Logistic regression analysis model.The risk factors of HCC MVI were obtained.Results:In this study,138 cases of HCC patients were collected,including 125 males(90.58%)and 13 females(9.42%);age 22-74,average age 52.41.Among the 138 patients,60 patients had MVI and 78 patients had no MVI.Firstly,in the single factor analysis,the general clinical data of the MVI group and no MVI group in gender(p=0.331),age(p=0.226),BMI(p=0.169),and HBsAg(p=0.201)had no statistical differences.Preoperative liver function and other serological indexes of the MVI group and no MVI group in ALB(p = 0.878),ALT(p = 0.970),AST(p = 0.242),TBil(p = 0.104),Child-Pugh classification(p = 1.000),AFP(p = 0.937),HBV-DNA quantification(p = 0.611),PLT(p = 0.773),PT(p = 1.000),and FIB(p = 0.073)had no statistical differences.There was also no statistical differences in tumor diameter(p=0.443),number of tumros(p=0.353),tumor necrosis(p=0.181),macrovascular invasion(p=0.102),liver cirrhosis(p=0.297),and the histopathological grading(p=0.709)between MVI group and no MVI group.However,there was significant statistical differences on the tumor margin(p=0.000)and the tumor shape(p=0.000).Furthermore,the multivariate Logistic regression analysis was used to analyze the tumor margin and the tumor shape.The tumor shape was compared with the nodular type.The result showed that the tumor margin(p=0.029)and the tumor shape of confluent multinodular(p=0.045)were the risk factors for MVI.Conclusions:The result of this study showed that the tumor margin and the tumor shape of confluent multinodular were the risk factors for MVI in HCC.These indicators may be helpful to the prediction of preoperative MVI of HCC.It is more likely that MVI will occur when the preoperative imaging findings show that the margin of the tumor is not smooth and the shape of tumor is confluent multinodular.It may help to improve the prognosis by adopting appropriate surgical methods and treatment options.Therefore,further research is needed.