| Objective 1.To analyze the influencing factors of microvascular invasion(MVI)in hepatocellular carcinoma(HCC).2.To investigate the predictive value of Protein Induced by Vitamin K Absence or antagonist-II(PIVKA-II)for HCC occurrence MVI;3.To Explore risk factors affecting the prognosis of HCC patients.Methods A total of 268 who were treated in the Affiliated Hospital of Southwest Medical University from January 1,2014 to March 1,2019 and diagnosed with HCC by pathology after surgical resection were enrolled.According to the pathological results,there were divided into two groups:experimental group(with MVI):78cases,control group(without MVI):190cases,using univariate and multivariate logistic regression analysis to predict Influencing factors of MVI in HCC.The receiver working curve(ROC curve)was used to evaluate the predictive value of PIVKA-II for MVI in HCC.Survival curve was drawn by kaplan-meier,and univariate and multivariate Cox proportional risk models were used to analyze the factors that affect patients’survival and prognosis.Results(1)Univariate analysis showed that PLR(Z=2.104,P=0.035),NLR(Z=3.486,P<0.001),PIVKA-II(Z=8.786,P<0.001),tumor size(χ~2=5.103,P<0.001),capsule type(χ~2=6.726,P<0.001)and differentiation degree(Z=5.476,P<0.001)were significantly different between the two groups(P<0.05).(2)Multivariate Logistic regression analysis showed that PIVKA-II(OR=3.216,P=0.004),tumor size(OR=1.621,P=0.012),capsule type(OR=3.254,P=0.008)and differentiation degree(OR=2.355,P=0.017)were independent risk factors for MVI in HCC patients(P<0.05).(3)The AUC,sensitivity and specificity of PIVKA-II in predicting MVI in HCC were 0.799,85.9%and 64.7%,respectively.The AUC,sensitivity and specificity of tumor size in predicting MVI in HCC were 0.675,71.8%and 58.9%,respectively.The AUC,sensitivity and specificity of PIVKA-II combined with tumor size in predicting MVI in HCC were 0.802,87.2%and 63.2%,respectively.(4)univariate Cox regression analysis showed that age(HR=1.022,P=0.008),PIVKA-II(HR=1.543,P=0.009),capsule type(HR=1.416,P=0.022),tumor differentiation degree(HR=1.721,P=0.030),MVI(HR=1.473,P=0.015)and PLR(HR=1.225,P=0.003)were correlated with the 1-year,3-year,and 5-year overall survival rates of HCC patients(P<0.05).(5)multivariate Cox regression analysis showed that PIVKA-II≥120mAU/mL(HR=1.510,P=0.025),poorly differentiated tumor(HR=1.613,P=0.042),MVI(HR=1.027,P=0.004),and PLR≥68.3(HR=1.151,P=0.016)were independent risk factors for the prognosis of HCC patients(P<0.05).(6)The median survival time of the high level group(PIVKA-II≥120mAU/mL)was 35 months,and the 1-year,3-year,and 5-year survival rates were 83.4%,44%,and 10.6%,respectively;the low-level group(PIVKA-II<120mAU/mL)was 43 months,and the 1-year,3-year,and 5-year survival rates were 85.6%,63.4%,and 23.2%,respectively(P=0.009).The median survival time of the experimental group was 33 months,and the 1-year,3-year and 5-year survival rates were 78.7%,45.7%and 15.4%,respectively.The median survival time of the control group was 42 months,and the 1-year,3-year and 5-year survival rates were 87.3%,56.4%and 29%,respectively(P=0.034).The median survival time of the highly differentiated group was 46 months,and the 1-year,3-year,and 5-year survival rates were87.7%,57.7%,and 34.3%,respectively.The median survival time was 35months in the moderately differentiated group,and the 1-year,3-year,and5-year survival rates were 81.1%,41.5%,and 24.2%,respectively;the median survival time was 33 months in the poorly differentiated group,and the 1-year,3-year,and 5-year survival rates were 78.4%,39.1%,and 16.2%,respectively(P=0.024).The median survival time of the high-value group(PLR≥68.3)was35 months,and the 1-year,3-year and 5-year survival rates were 84.4%,45.4%and 25.3%,respectively.The median survival time of the low-value group(PLR<68.3)was 46 months,and the 1-year,3-year and 5-year survival rates were 88.7%,60.7%and 34.5%,respectively,with statistically significant differences(P=0.026).Conclusion(1)PIVKA-II was an independent factor influencing the occurrence of MVI in HCC.(2)PIVKA-II combined with tumor size has good predictive value of MVI in HCC.(3)Patients with PIVKA-II≥120mAU/mL,PLR≥68.3,MVI and poorly differentiated HCC had poor prognosis. |
