Risk factors analysis and prognosis of the microvascular invasion of hepatocellular carcinoma / 中华消化外科杂志

ABSTRACT

Objective To explore the risk factors and prognosis of the microvascular invasion of hepatocellular carcinoma (HCC).Methods The retrospective case-control study was conducted.The clinicopathological data of 220 patients with HCC who were admitted to the Nanfang Hospital of Southern Medical University from July 2012 to July 2015 were collected.Among 220 patients,63 were confirmed with microvascular invasion of HCC by postoperative pathological examination after radical resection of HCC and 157 were not confirmed with microvascular invasion of HCC.Observation indicators:(1) univariate and multivariate analyses affecting microvascular invasion of HCC;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival and tumor recurrence up to July 2016.The univariate and multivariate analyses were done using the Logistic regression model.The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Results (1) Univariate and multivariate analyses affecting microvascular invasion of HCC:the results of univariate analysis showed that maximum diameter of tumor,preoperative alpha-fetoprotein (AFP) and preoperative platelet (PLT) were related factors affecting microvascular invasion of HCC [OR =4.542,1.576,3.655,95％ confidence interval (CI):2.433-8.470,1.084-2.292,1.985-6.831,P＜0.05].The results of multivariate analysis showed that maximum diameter of tumor,preoperative AFP and preoperative PLT were independent factors affecting microvascular invasion of HCC (RR=3.386,1.563,2.247,95％CI:1.703-6.729,1.054-2.318,1.135-4.451,P＜0.05).(2) Follow-up and survival situations:220 patients were followed up for 12-48 months,with a median time of 26 months.The postoperative overall 1-and 2-year survival rates,postoperative 1-and 2-year tumor-free survival rates were 77.3％,50.0％,47.3％,38.0％ in 63 patients with microvascular invasion of HCC and 92.4％,77.2％,74.5％,69.4％ in 157 patients without microvascular invasion of HCC,with statistically significant differences (x2 =10.480,19.605,14.677,18.461,P＜ 0.05).Conclusion The maximum diameter of tumor,preoperative AFP and preoperative PLT are independent factors affecting microvascular invasion of HCC,and patients with microvascular invasion of HCC have poor clinical prognosis.