原发性肝细胞癌发生MVI的危险因素分析

Analysis of risk factors of MVI in primary hepatocellular carcinoma

目的探究影响原发性肝细胞癌发生MVI的危险因素。方法回顾性分析2017年1月至2019年10月于南充市中心医院进行完整切除富血供的136例原发性肝细胞癌患者的临床资料,所有患者术前2~3 d均行超声造影检查,以术后病理学诊断结果为金标准,分为非MVI组(54例)和MVI组(82例)。观察超声造影的肿瘤切片,并计算T、L比值(T/L);比较两组患者的临床资料,并进行单因素分析与多因素非条件Logistic回归分析,筛选影响原发性肝细胞癌发生MVI的危险因素。结果136例原发性肝细胞癌患者中有54例(39.71%)未发生MVI,82例(60.29%)发生MVI。单因素分析显示,MVI组肿瘤直径>5 cm、肿瘤数目≥2个、T/L≥0.33、二维超声的肿瘤形态不规则,且二维超声的肿瘤边缘毛刺的患者占比高于非MVI组;将单因素分析中差异有统计学意义的指标作为自变量,纳入多因素非条件Logistic回归模型进行分析,结果显示,肿瘤数目≥2个、T/L≥0.33是原发性肝细胞癌发生MVI的危险因素(OR=11.212、18.083,均P<0.05)。结论肿瘤数目≥2个、T/L≥0.33为原发性肝细胞癌患者发生MVI的危险因素,可为临床诊治提供参考依据。

Abstrac:Objective To investigate the risk factors of MVI in primary hepatocellular carcinoma.Methods Retrospective analysis was performed on the clinical data of 136 patients with primary hepatocellular carcinoma who underwent complete resection of blood rich supply in Nanchong Central Hospital from January 2017 to October 2019,all patients underwent contrast-enhanced ultrasound 2~3 days before operation.The patients were divided into non MVI group(54 cases)and MVI group(82 cases)according to the gold standard of postoperative pathological diagnosis.The tumor sections were observed by contrast-enhanced ultrasound(CEUS)and the ratio of T and L(T/L)was calculated;The clinical data of the two groups of patients were compared,and univariate analysis and multivariate unconditioned Logistic regression analysis were performed to screen the risk factors affecting primary hepatocellular carcinoma(HCC)MVI.Results Among the 136 patients with primary hepatocellular carcinoma,54 cases(39.71%)had no MVI and 82 cases(60.29%)had MVI.Univariate analysis showed that,in MVI group,the proportion of patients with the tumor diameter of the MVI group>5 cm,the number of tumors≥2 number,the T/L ratio≥0.33,the tumor morphology of two-dimensional ultrasound was irregular,and the number of tumor marginal burrs of two-dimensional ultrasound was higher than that of the non MVI group;the indexes with statistically significant differences in univariate analysis were taken as independent variables and included in multivariate Logistic regression model for analysis.The results showed that the number of tumors≥2 and T/L≥0.33 were risk factors of MVI in primary hepatocellular carcinoma(HCC)(OR=11.212,18.083,all P<0.05).Conclusion The number of tumors≥2 and T/L≥0.33 are the risk factors of MVI in patients with primary hepatocellular carcinoma,which can provide a reference basis for clinical diagnosis and treatment.