Analysis Of Clinical Factors Of Microvascular Invasion In Primary Hepatocellular Carcinoma And Its Effect On Prognosis

Objective:To determine the clinical risk factors of Microvascular invasion(MVI)of Hepatocellular carcinoma(HCC)and its effect on the prognosis of patients.Method:The clinical and follow-up data of 112 HCC patients who received radical resection in Hepatobiliary Surgery of Hunan provincial people's hospital from June 2014 to June 2017 were retrospectively analyzed.According to the presence of microvascular invasion divided into MVI group(n=38)and non-MVI group(n=74).Univariate and multivariate logistic regression was used to analyze the clinical risk factors for microvascular invasion of HCC.Kaplan-meier test and log-rank test were used to conduct univariate survival analysis of patients' recurrence time and survival time,Kaplan-meier method was used to calculate the survival rate and draw the survival curve.Cox regression risk ratio model was used to analyze the multivariate survival of the factors affecting the prognosis.Results:(1)Univariate logistic regression analysis: tumor number,tumor size,tumor differentiation degree,alpha-fetoprotein level,and presence of hypersplenism in HCC patients were related risk factors for MVI(p<0.05).Multivariate Logistic regression analysis: the number of tumors,tumor size,tumor differentiation degree and the presence of hypersplenism in HCC patients were independent risk factors for MVI(P < 0.05).(2)Univariate COX regression analysis showed that the factors related to recurrence and prognosis of HCC patients(p<0.05)were tumor size,tumor number,liver cirrhosis,and microvascular invasion in order of Wald value.Results of multivariate COX regression analysis(p<0.05)were tumor size,tumor number,and microvascular invasion according to Wald value.(3)The overall survival rate of patients in the MVI group at 1 and 2 years after surgery was 82.2% and 61.5%,and the Disease-free survival rate at 1 and 2 years after surgery was 60.8% and 50.0%.The overall survival rate of the patients in the non-MVI group was 90.3% and 78.6%,and the Disease-free survival rate was 80.4% and 68.7%,respectively.The survival rate in the MVI group was lower than that in the non-MVI group,and there was a statistically significant difference between the two groups(P < 0.05).Conclusion:(1)MVI was correlated with tumor size,tumor number,tumor differentiation degree and presence of hypersplenism in HCC patients.(2)MVI is an independent risk factor affecting the prognosis of HCC patients,which has a negative effect on the prognosis.