肝细胞癌微血管侵犯的影响因素及其预测价值

Influencing Factors of Microvascular Invasion in Hepatocellular Carcinoma and Its Predictive Value

目的:肝细胞癌微血管侵犯(microvascular invasion,MVI)的影响因素及其预测价值。方法:回顾性选取广西医科大学附属肿瘤医院肝胆外科2018年1月1日-2020年6月30日首次入院并进行肝癌根治术,术后病理确诊为肝细胞癌的190例患者。根据术后病理报告将其成MVI组(108例)和非MVI组(82例)。采集两组临床资料,采用单因素和多因素Logistic回归分析肝癌MVI发生的独立危险因素,使用受试者工作特征曲线分析肿瘤最大直径的价值。结果:MVI组BMI低于非MVI组,吸烟占比、甲胎蛋白(AFP)≥400 ng/ml占比均高于非MVI组,肿瘤最大直径大于非MVI组(P<0.05)。多因素Logistic回归分析表明肿瘤最大直径是肝癌MVI发生的独立危险因素(P<0.05)。肿瘤最大直径曲线下面积(AUC)为0.653(95%CI:0.574,0.732,P<0.000 1)。结论:在原发性肝细胞癌患者中,有吸烟史、BMI降低、高AFP、肿瘤直径较大的患者,存在微血管侵犯的可能性大。肿瘤最大直径是MVI的独立危险因素。

Objective:To explore the influencing factors of microvascular invasion (MVI) in hepatocellular carcinoma and its predictive value.Method:A total of 190 patients with hepatocellular carcinoma who were first admitted to the hepatobiliary surgery department of Guangxi Medical University Cancer Hospital from January 1,2018 to June 30,2020 and underwent radical resection of liver cancer were retrospectively selected.According to the postoperative pathological report,they were divided into MVI group (108 cases) and non MVI group (82 cases).The clinical data of the two groups was collected,and univariate and multivariate Logistic regression were used to analyze the independent risk factors for the occurence of MVI in hepatocellular carcinoma.The values of tumor maximum diameter was analyzed using the receiver operating characteristic curves.Result:The BMI of MVI group was lower than that of non MVI group,the proportion of smoking,the proportion of alpha fetoprotein (AFP) ≥400 ng/ml were higher than those of non MVI group,and the tumor maximum diameter was greater than that of non MVI group (P<0.05).Multivariate Logistic regression analysis showed that the tumor maximum diameter was independent risk factors for the occurence of MVI in hepatocellular carcinoma (P<0.05).The area under curve (AUC) of the tumor maximum diameter was 0.653 (95%CI:0.574,0.732,P<0.000 1).Conclusion:Among patients with primary hepatocellular carcinoma,those with a history of smoking,decreased BMI,high AFP and larger tumor diameter are more likely to have MVI.Tumor maximum diameter is independent risk factors for MVI.