Analysis Of The Biological And Serological Characteristics Of MVI In HCC

Objective By analyzing the general clinical data,tumor characteristics,serum inflammatory indexes,blood coagulation and liver function of the patients with HCC,the independent risk factors for preoperative microvascular cancer thrombus grading of HCC were predicted,so as to guide the selection of treatment options and evaluate the prognosis of the patients with HCC.Methods Data of 158 patients with HCC who received surgical treatment in Ningxia Medical University General Hospital from January 2016 to December 2020 and who met the requirements of this study were retrospectively analyzed.General information of patients(gender,age,Child-Pugh score of liver function,body mass index(BMI),hepatitis B history)were included.Tumor characteristics(tumor diameter,tumor number,tumor envelope integrity,tumor differentiation,tumor Barcelona stage(BCLC stage),alpha fetoprotein(AFP));Serum inflammatory indicators(neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),aspartate aminotransferase-platelet count ratio(APRI),alkaline phosphatase-lymphocyte ratio(ALR),lymphocyte-monocyte ratio(LMR),γ-glutamyltranspeptidase-platelet ratio(GPR),white blood cell count(WBC),neutrophil count(NEUT),lymphocyte count,monocyte count(MXD)).Clotting and liver function,serum index(D-dimer,prothrombin time(PT),aspartate aminotransferase(AST),alanine aminotransferase(ALT),albumin,alkaline phosphatase(ALP)and gamma GGTP(gamma glutamyl transpeptidase)(GGT),total bilirubin,red blood cell count(RBC),red blood cell volume distribution width(RDW),platelet count,Liver fibrosis index FIB-4(age *AST/ platelet count *ALT square root).According to the postoperative pathological biopsy results of patients,MVI was divided into three groups: M0(thrombi-free group),M1(low-risk group)and M2(high-risk group).Univariate analysis was conducted on the relevant data of patients in each group,and then the data with P<0.1 were included in the multivariate regression analysis as independent variables to construct an ordered multi-classification Logistic regression model.Finally,the diagnostic efficiency of Logistic regression model was evaluated by ROC curve.The statistical analysis results were unified as P<0.05,which was considered statistically significant,and the independent risk factors for the grading of microvascular tumor thrombus were finally determined.Results Clinical data of 158 patients meeting the inclusion and exclusion criteria were collected,including 113 male patients(71.52%)and 45 female patients(28.48%).Among them,85 cases(53.80%)were found in M0 group,58 cases(36.71)in M1 group,and 15 cases(9.49%)in M2 group.The general information,tumor characteristics,serum inflammatory indexes,coagulation and other serum indexes of the patients were statistically analyzed,and the results showed that there were statistically significant differences in tumor diameter,tumor capsule integrity,AFP,tumor BCLC stage,NEUT,WBC and GGT among all groups(P <0.05).With tumor diameter,tumor capsule integrity,AFP,tumor BCLC stage,age,NEut,WBC,NLR and GGT as independent variables(P < 0.1),ordered multi-classification logistic regression analysis was performed.The results showed that tumor capsule integrity,tumor Barcelona stage,tumor diameter,patient age,NLR and GGT were independent risk factors for MVI stage.Further ROC curve analysis showed that when the tumor diameter>8.5cm,GGT>54.2U/L,NLR>1.675,the prediction of M2 stage of microvascular tumor thrombus was more reliable.Conclusion Tumor envelope integrity,tumor BCLC stage,tumor diameter,patient age,NLR and GGT were independent risk factors for MVI stage.When the cut-off values of tumor diameter,GGT and NLR reached 8.5cm,54.2U/L and 1.675,respectively,it was reliable to predict the grade of M2 of microvascular tumor thrombus.