肝癌微血管侵犯的特点及相关临床指标

The characteristics and related biomarkers of microvascular invasion in hepatocellular carcinoma

目的研究肝癌微血管侵犯(MVI)的临床和病理特点。方法筛选144例小肝癌,分成MVI组(67例)和无MVI组(77例),统计两组临床资料,对比生存率,寻找MVI相关的临床指标,研究MVI的病理特点。结果小肝癌MVI阳性率46.5%(67例),中位生存期37.8个月,术后1、3、5年累积生存率是86.5%、44.7%、35.8%;无MVI组中位生存期68.2个月,术后1、3、5年的累积生存率分别是93.3%、84.5%、75.3%;两组比较差异有统计学意义(χ2=6.18,P=0.012)。瘤体越大,MVI发生率越高;病理分级越低,MVI发生率越高。结合病理学观察,提示MVI是一个逐步进展的过程。结论 MVI是肝癌恶性进展的关键点和患者预后的转折点,肿瘤大小、分化程度与其密切相关。针对MVI的治疗是改善患者预后的重要切入点,对肝癌研究和综合治疗具有指导意义。

Objective To study the clinicopathological characteristics of microvascular invasion(MVI)inhepatocellular carcinoma(HCC).Methods A total of144patients with small HCC were screened and were dividedinto MVI group and no MVI group.Clinical datas were counted,survival rates were compared,biomarkersof MVI were searched and pathological characteristics of MVI were observed.Results The rates of small HCC(SHCC)with MVI were46.5%(67cases),the median survival was37.8mon.And the1-,3-and5-year cumulativesurvival rates was86.5%,44.7%and35.8%,that was worse than those without MVI.The larger the tumor,the higher the rate of MVI.The lower histological grade,the higher the rate of MVI.Through pathological observation,it was indicated that MVI is a gradual process of progress.Conclusion MVI is the key point of HCCprogression and the turning point of prognosis.Tumor size and differentiation are closely related to MVI.Thetreatment of MVI is an important entry point to improve the prognosis of patients,with guiding significance forHCC research and comprehensive treatment.