The impact factors for pathologic micro-invasion of hepatocellular carcinoma: possible application for CTV definition / 中华放射肿瘤学杂志

ABSTRACT

Objective To evaluate the microscopic characteristics of hepatocellular carcinoma (HCC) invasion,and to provide the reference for GTV-to-CTV expansion. Methods From January 2002 to January 2006,149 HCC patients treated by surgical resection were included. The pathologic slices and clinical data were reviewed, including the tumor size, capsule status, tumor edge, portal vein invasion, TNM stage, histology grade, serum alpha-fetoprotein (AFP), platelet count and the degree of liver cirrhosis. The distance between the tumor capsule and the invasion was measured by 2 senior pathologists. Results of the 149 patients evaluated,79(53.0%) patients presented micro-invasion ranged between 0.5-4.0 mm. The recurrence rate was higher in patients with micro-invasion than those without (44% vs 29%, P=0.047). The invasion extent was positively relative to the tumor size, capsule status, tumor edge, portal vein invasion, TNM stage,histology grade and AFP,while negatively relative to the platelet count. A score system was established according to five predictors of tumor size, capsule status, portal vein invasion, AFP and platelet count. The invasion distance below 2 mm was in 96.6% patients who had≤2 points and only 83.3% for those with 2 points. Conclusions For HCC patients,the invasion extent is relative to the tumor size,cap sule status,portal vein invasion, AFP and platelet count. These 5 predictors could be potentially used as a score system for GTV-to-CTV expansion.