Analysis Of Risk Factors On Microvascular Invasion In Patients With Small Hepatocellular Carcinoma

ObjectiveTo explore the risk factors of microvascular invasion(MVI)in patients with small hepatocellular carcinoma(HCC),and to investigate the influence of MVI on the prognosis of small HCC patients.MethodsThe retrospective case-control study was conducted.The clinical data of 50patients diagnosed as small HCC with MVI in the First Affiliated Hospital of Zhengzhou University from June 2012 to June 2017,and 90 patients by random pick from those diagnosed as small HCC without MVI in the same period were collected.All patients had complete clinical information and received surgical treatment.The clinical data of these small HCC patients were collated and analyzed by SPSS 21.0software.The clinicopathological features of the two groups were analyzed by using the Chi-square test or Fisher exact test,and the risk factors for MVI in patients with small HCC were determined by unconditional Logistic regression analyses.The survival curve were drawn by the Kaplan-Meier method.The Log-rank test was used to compare the survival differences between the two groups and to analyze the effect of MVI on survival and prognosis of small HCC patients.ResultsUnivariate analysis showed that the proportions of cases with AFP>25 ng/mL,GGT>50 U/L,maximum tumor diameter larger than 3 cm and poorly differentiated degree in patients with MVI were singinifcantly higher than those in patients without MVI(all P<0.05).However,there were no significant associations of MVI with age,gender,history of cirrhosis,history of chronic viral hepatitis,BCLC staging,Child-Pugh grade,leukocyte,neutrophil,lymphocyte,platele,PT,INR,ALT,AST,serun total bilirubin and albumin(all P>0.05).Unconditional logistic regression analysis revealed that AFP level(OR=3.155,95%CI=1.124~8.859,P=0.029),GGT level(OR=2.985,95%CI=1.280~6.960,P=0.011)and maximum tumor diameter(OR=8.357,95%CI=3.405~20.509,P<0.001)were independent risk factors for small HCC with complicated MVI.All groups of 140 patients were followed up.The overall survival in MVI group was significantly lower than that in non-MVI group(?~2=4.598,P=0.032).Besides,66 MVI patients gained follow-up for 3 years,and the 3-year survival rates of20 MVI cases and 46 non-MVI cases were 62%and 75%respectively.Conclusion1.The AFP level,GGT level and maximum tumor diameter are independent risk factors for complicated MVI in patients with small HCC.2.The overall survival of MVI in patients with small HCC was significantly lower than that in non-MVI group,suggesting poor clinical prognosis.