| Hepatocellular carcinoma is one of the most common digestive system malignancies worldwide.Its incidence rate and mortality rate are high and aggressive.Now the most effective radical cure is radical resection and liver transplantation,but even so,the prognosis of HCC is still poor.There are many factors affecting the prognosis of HCC,such as tumor differentiation,number,size,metastasis and so on.More and more clinical studies have found that the recurrence rate is significantly increased and the survival rate is significantly decreased in patients with microvascular invasion confirmed by postoperative pathology.Therefore,the malignancy and prognosis of HCC may not be absolutely related to tumor size,but depends on whether there is early microvascular invasion.It has been reported that MVI can penetrate the capsule and infiltrate into the blood vessels 1 cm outside the tumor edge.Therefore,when patients with MVI are operated on,the resection margin can be enlarged with the permission of liver function.In conclusion,to study the prognostic factors of MVI can provide a new theoretical basis and strategy for preoperative treatment and prognosis evaluation of hepatocellular carcinoma.Objective: To study the risk factors of hepatocellular carcinoma with MVI by analyzing the clinical data of patients with hepatocellular carcinoma who underwent radical resection in our hospital The purpose of this study is to provide a theoretical basis for preoperative treatment and prognosis evaluation of patients with hepatocellular carcinoma,and to further analyze the significance and role of MVI in the occurrence and development of hepatocellular carcinoma,so as to provide a new theoretical basis and strategy for preoperative warning,prognosis evaluation and guiding treatment of hepatocellular carcinoma.Materials and methods: from January 2015 to December 2017,the patients with hepatocellular carcinoma who underwent radical surgery in general hospital of Ningxia Medical University were retrospectively analyzed.The clinical,imaging,pathological data and postoperative follow-up data were collected and divided into two groups,the group with microvascular invasion and the group without microvascular invasion(1)The x~2/T test was used to test the above data and analyze the relationship between the above indicators and microvascular invasion of HCC cells;(2)Kaplan Meier survival curve was used to analyze the relationship between the above indicators and tumor free survival time and cumulative survival time of patients.Univariate survival analysis was used to screen the prognostic factors of HCC patients with MVI by Cox regression risk ratio model It’s plain.Results:(1)there were no significant differences between MVI group and non MVI group in gender,age,hypertension,diabetes,TBIL,ALB,alt,Pt,tumor diameter,degree of differentiation,liver cirrhosis,operation time,blood loss,porta hepatis block time,invasion of capsule and satellite focus(P>0.05).The AFP and tumor number in MVI group were significantly higher than those in non MVI group(P<0.05).But the history of liver disease(HBV / HCV)and AST in MVI group were significantly lower than those in non MVI group(P<0.05).(2)Kaplan Meier survival curve analysis: the mean disease-free survival time and mean cumulative survival time of MVI group were significantly shorter than those of non MVI group,with statistically significant differences(P<0.05);the1-year,2-year,3-year cumulative survival rates of MVI group and non MVI group were 72.7% vs 96.3%,56.4% vs 79.8%,and 50.9% vs 75.2%,with statistically significant differences(P=0.000).The 1-year,2-year,and 3-year disease free survival rates in MVI group were 43.6% vs 67.9%,38.2% vs 56.9%,and 36.4% vs 54.1%,respectively,with statistically significant differences(P=0.005).(3)Kaplan Meier survival curve analysis showed that tumor diameter and postoperative adjuvant therapy were associated with postoperative tumor free survival time of hepatocellular carcinoma with MVI;Cox regression analysis showed that tumor diameter and postoperative adjuvant therapy were independent risk factors of postoperative tumor free survival time of hepatocellular carcinoma with MVI.Univariate analysis showed that age,Pt,tumor diameter and postoperative adjuvant therapy were associated with the overall survival time of HCC with MVI;Cox regression analysis showed that tumor diameter PT was an independent risk factor for the cumulative survival time of HCC with MVI.Conclusion: 1.MVI can significantly shorten the postoperative tumor free survival time and cumulative survival time of HCC,which is one of the important risk factors for the prognosis of HCC.2.MVI was correlated with liver disease history(HBV / HCV),AFP and AST levels and tumor number.3.Tumor diameter and postoperative adjuvant therapy were independent risk factors of tumor free survival time after radical resection of hepatocellular carcinoma;Pt and tumor diameter were independent risk factors of cumulative survival time after radical resection of hepatocellular carcinoma. |
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