Risk Factors Of Microvascular Invasion In Primary Liver Cancer

Objective Microvascular invasion(MVI)is an important factor for predicting early recurrence of primary liver cancer(PLC)after operation,and also a significant pathological index for guiding the prevention of recurrence after operation.However,up to now,there is no effective method to predict the existence of MVI before operation,and it can only be diagnosed by pathological examination of tumor specimens after operation.Preoperative MVI prediction is of great significance to the formulation of treatment plan.Therefore,this study aims to analyze the related risk factors of primary liver cancer with microvascular invasion,and to explore the prediction of MVI before operation,so as to provide the basis for the reasonable formulation of a preoperative treatment plan.Methods Clinical data of PLC patients after operation meeting the screening criterias at the General Hospital of Ningxia Medical University of department of hepatobiliary sugery during June 2013 to June 2018 were collected,including the general clinical data(gender,age,history of hepatitis B,history of cirrhosis and history of diabetes)and serological indicators(AFP,total bilirubin,albumin,ALT,AST,GGT,ALP,PLT,and Neutrophil-to-lymphocyte Ratio(NLR)as well as postoperative pathological data(tumor number,tumor diameter,differentiation of tumor,presence or absence of MVI)associated with MVI.According to the pathological report of the patients whether the existence of MVI,all of these data will be divided into combined MVI group and non-MVI group.The correlation between these data and MVI is analyzed by single factor analysis method.The P <0.05 indicates that there is significant difference between the two groups.Statistically significant factors are further included in the multivariate logistic regression analysis model to screen out independent risk factors for PLC with MVI.Results A total of 166 cases of PLC are collected,including 106 males(63.86%)and60 females(36.14%).The average age is 55.02±10.15 years,the youngest is 39 years and the oldest is 78 years.Among them,96 cases(57.83%)are in the group with MVI and 70 cases(42.12%)are in the group without MVI.Firstly,single factor analysis method is made on the related indicators of MVI.There are no statistical differences in gender(P = 0.832),age(P =0.080),history of hepatitis B(P = 0.279),history of cirrhosis(P = 0.066),history of diabetes(P= 0.081)between the combined MVI group and the non-MVI group in the general clinical data of patients(P > 0.05).There are no significant differences in total bilirubin(P=0.300),albumin(P=0.651),ALT(P=0.417),AST(P=0.254),ALP(P=0.140)and PLT(P=0.296),but there are significant differences in AFP(P=0.007),GGT(P=0.000),NLR(P=0.000)(P<0.05).Pathological data of MVI group and non-MVI group showes significant differences in tumor diameter(P=0.000)and differentiation of tumors(P=0.001)(P<0.05).Preoperative serum AFP,GGT,NLR,tumor diameter and differentiation of tumor are included in the multivariate logistic regression analysis.Serum AFP(P=0.043),GGT(P=0.011)and tumor diameter(P=0.016)are independent risk factors for PLC with MVI.Conclusion Preoperative serum AFP,GGT,NLR,tumor diameter and tumor differentiation are associated with the occurrence of MVI in PLC,but preoperative serum AFP,GGT and tumor diameter are independent risk factors for MVI.