肝细胞癌微血管侵犯与临床病理指标的相关性

Relationship between microvascular invasion and clinicalpathological characteristics in hepatocellular carcinoma patients

目的:探讨肝细胞癌微血管侵犯与临床病理特征之间的相关性。方法 :选取2015年6月—2017年4月行手术治疗并且术后病理结果确诊为肝细胞癌的76例患者作为研究对象,根据是否存在微血管侵犯情况分为MVI组(n=50)和无MVI组(n=26)两组,采用单因素分析与Logistic多因素回归分析探讨MVI发生与肿瘤临床病理特征之间的相关性。结果:肝细胞癌患者中MVI发生率为65.79%(50/76),经单因素分析和Logistic多因素回归分析结果显示MVI的发生与肿瘤直径(P<0.001)、肿瘤病理分级(P<0.001)具有相关性,但与性别、年龄、肿瘤数目、AFP、Ki67阳性率、脉管内悬浮癌细胞数、胆管侵犯情况无明显相关性。结论:肝细胞癌微血管侵犯与肿瘤直径、肿瘤病理分级具有明显相关性。患者在术前行影像学检查明确肿瘤直径,有助于预测MVI的发生,从而对于肝癌患者手术方式的选择及术后综合治疗(靶向药物、TACE等)具有一定的临床指导意义。

Objective： To explore the correlation between microvascular invasion and clinical- pathological characteristics in hepatocellutar carcinoma （HCC） patients. Methodst 76 HCC patients,treated and diagnosed by pathological examination during 2015.06-2017.04 in our department, were divided into MVI group and no MVI group according to the status of microvascular invasion. All clinical- pathological data were collected and analyzed by chi-square test and multiple logistic regression anal- ysis. Results： Of 76 consecutive HCC patients,50（65.79%）were founded to have a microvascular in- vasion. Tumor diameter （ X2= 14.148, P〈0.001 ）, tumor pathological grade （X2= 15.382, P〈0.001 ）were correlated with MVI. Logistic multivariate analysis showed that tumor diameter d≥3 cm and tumor pathological grade were independent risk factors for MVI. Conclusion： Tumor diameter and tumor pathological grade differentiation are independent risk factors for MVI. Determinations of tumor diame- ter by imaging examination and tumor pathological grade by liver biopsy preoperratively will provide us a novel clinical strategy of the prediction of the occurrence of MVI, so as to provide clinical guidances for determining surgical methods and postoperative comprehensive treatment in HCC patients.