| Objective: To investigate the correlation between microvascular invasion and prognosis of hepatocellular carcinoma,and explore the risk factors of microvascular invasion.Methods: A retrospective cross-sectional study was conducted.From January 2014 to October 2017,the clinicopathological data of patients with hepatocellular carcinoma who underwent primary resection of liver at the First Affiliated Hospital of Guangxi Medical University were collected.There were163 cases,including60 cases with 1 year recurrence and 103 cases without 1year recurrence.The pathological grading of MVI was made according to the Guidelines for diagnosis and treatment of primary liver cancer(2019Edition).They were divided into group M0(n=117 cases)and group M1(n=46cases).Single factor analysis was used to analyze the clinical and pathological characteristics of two groups of patients in group M1 and group M0,such as sex,age,tumor number,tumor diameter,gross tumor type,pathological grade,microvascular invasion,liver cirrhosis,hepatitis B virus surface antigen(HBs Ag)and Barcelona stage(BCLC stage).Multivariate Logistic regression analysis was used to identify the independent risk factors for MVI.The clinical and pathological data of 1 year no recurrence group and 1 year recurrence group were analyzed by the same single factor analysis,and the related factors of early postoperative recurrence were identified.Multivariate Logistic regression analysis was used to identify the independent risk factors for recurrence of hepatocellular carcinoma after operation.The mean tumor free survival time and standard deviation of M1 group and M0 group were calculated respectively.Kaplan-Meier method was used to draw the tumor free survival curve of patients with hepatocellular carcinoma,and the difference of tumor free survival curve was detected by log-rank method.Results: Univariate and multivariate analysis showed that pathological grade was an independent risk factor for MVI.The incidence of MVI in pathological grade I+II was 29.1%(n=127),and the incidence of MVI in pathological grading of III+IV was 65.7%(n=35).The difference was significant(P<0.01).The risk factors for 1 year recurrence of hepatocellular carcinoma(P<0.01)were the vascular tumor thrombus,pathological grading,and tumor complete capsule.The results of multivariate analysis showed that MVI,pathological grading,and tumor complete capsule were independent risk factors for postoperative recurrence in patients with hepatocellular carcinoma.The1 year recurrence rate in group M1 was 52.20%(n=46),and the 1 year recurrence rate in group M0 was 30.80%(n=117).The difference was significant(P<0.01);the 1 year recurrence rate of pathological grade I+II was 29.10%(n=128),and the recurrence rate of 1 years with pathological grading of III+IV was 65.70%(n=35),and the difference was significant(P<0.05);the recurrence rate of 1 years without complete capsule group was 54.7%(n=75),and the recurrence rate of complete capsule group was 21.6%(n=88)in 1 years,with significant difference(P<0.05).Log-rank method was used to test the tumor free survival curves of each group.The survival time of M1 group was significantly lower than that of group M0(P<0.05),and the mean tumor free survival time in group M0 was 17.7±1 months,the median tumor free survival time was 16±0.9 months,the average survival time in group M1 was 9.4±1.1 months,and median survival time was 5±1.6 months.Conclusion:1.Hepatocellular carcinoma with microvascular invasion is an independent risk factor for prognosis of hepatocellular carcinoma after simple surgery.2.Pathological grading is an independent risk factor for MVI.3.Tumor capsule and pathological grading are also an independent risk factor for prognosis of hepatocellular carcinoma after simple surgery. |
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