Construction of clinical scoring system for predicting microvascular invasion in preoperative hepatocellular carcinoma / 中华普通外科杂志

ABSTRACT

Objective:To analyze the risk factors of hepatocellular carcinoma microvascular invasion (MVI) and to construct a preoperative prediction clinical scoring system.Methods:A retrospective analysis was made on 113 patients with hepatocellular carcinoma undergoing hepatectomy at Zhongshan Hospital from March 2018 to Jun 2019.Postoperative pathology confirmed 35 cases with microvascular invasion.Results:The multivariate logistic regression model showed that the maximum tumor diameter( OR 1.028, 95% CI 1.001-1.005), the smoothness of the capsule edge( OR 0.208, 95% CI 0.062-0.699), the positive circulating tumor cells (CTC)( OR 3.728, 95% CI 1.029-13.501) and abnormal prothrombin(PIVKA-Ⅱ)( OR 1.001, 95% CI 1.000-1.002) were risk factors for MVI. The area, sensitivity and specificity of the clinical score constructed by assigning 1 point to each risk factor were 0.906, 74.29% and 92.31%, respectively. Clinical scores of 0, 1, 2, 3, and 4 predict MVI positive rates of 0 (0/26), 9.09% (3/33), 28.57% (6/21), 77.78% (14/ 18), 85.71% (12/14). Conclusions:Tumor maximum diameter>62 mm, PIVKA-Ⅱ>115 mAU/ml, unsmooth tumor capsule and CTC in peripheral blood are independent high risk factors in patients with MVI.