| Objective:By analyzing the clinical data of patients with HCC,to explore the influence of current microvascular invasion on the prediction of recurrence of HCC after resection,and to compare with the classical clinical tumor staging,to study its value in the prediction of tumor free survival time of patients.Methods:A retrospective analysis was used to collect 272 cases of pathological diagnosis of HCC after surgical resection from May 2015 to may 2018 in hepatobiliary surgery,the Second Affiliated Hospital of Kunming Medical University.In this study,patients who met the criteria were divided into recurrence group(RG)and non recurrence group(NG).To analyze the correlation between the two groups of patients and recurrence in general information,tumor pathological characteristics and laboratory indicators,focusing on the significance of microvascular invasion on recurrence.In single factor analysis,t test was used for measurement data conforming to normal distribution;Mann Whitney U test was used for unsatisfied data;chi square test was used for counting data;binary logistic regression model was used to analyze independent risk factors of recurrence.In survival analysis,Kaplan Meier method was used to analyze the independent risk factors and cl inicopathological stages,and to explore the influence of each system on tumor free survival time(RFS)of patients with HCC after operation.Log rank method was used for comparison between groups,and survival curve was drawn.Finally,the prediction value of c-index is calculated by single factor Cox regression model.Results:For this research,100 patients with complete data and detailed follow-up records were selected.In this paper,the author analyzes the characteristics of.Logistic regression analysis showed that microvascular invasion(or=1.25,95%CI 1.0247-11.908,P=0.046)and satellite nodule(or=1.852,95%CI 1.207-33.644,P=0.029)were independent risk factors for recurrence of HCC.In survival analysis,single factor K-M analysis showed that microvascular invasion(x2=12.049,P<0.001),Barcelona tumor stage(BCLC)(χ2=5.047,P<0.001),TNM stage(χ2=17.223,P<0.001)had significant significance in predicting postoperative tumor free survival time(RFS).The c-index values of the above three systems were:microvascular invasion(C-index=0.598,95%CI 0.526-0.672),BCLC stage(C-index=0.600,95%CI 0.522-0.678),TNM stage(C-index=0.659,95%CI 0.584～0.735).The difference was statistically significant(P<0.05).Conclusion:It is not enough to evaluate the pathological behavior of tumor only by considering the size of tumor.Microvascular infiltration,as a new prognostic index of liver cancer,has considerable application value.Compared with patients with no or mild microvascular invasion,patients with severe microvascular invasion had a significantly higher risk of recurrence,while RFs was significantly shorter.The factors related to recurrence,such as tumor boundary,satellite nodule and HBV infection,have potential relationship with MVI.The existing MVI classification system has a considerable predictive value for predicting early postoperative recurrence of HCC patients.Although MVI can only be identified from postoperative pathological examination at present,because there is still room for improvement in the current grading system,its prediction potential is great,and it is worth investing resources for in-depth research. |
