| Hepatocellular carcinoma(HCC)is one of the most common malignant tumors in both the world and China.The incidence of HCC is high and the prognosis is poor.It is always at the late stage when it was diagnosed due to lack of specific symptoms at the earlier stage and lost the best opportunity of treatment.An important factor that impact the prognosis of HCC is its behavior of likely to recurrence and metastasis quickly postoperative.In addition,there are many other factors which determine the prognosis of HCC,including tumor size,quantity,and presence of vascular invasion and so on.Increasing clinical observations indicated that the size of the tumor is not absolute the matter of prognosis,because of the earlier microvascular invasion was found in even some smaller tumors,but not larger tumors,suggesting that the earlier microvascular invasion may be important in predicting the malignant behavior of tumor cells and the prognosis of HCC patients.Therefore,it is drawing more people attention on microvascular invasion on the invasive behavior and prognosis of HCC recently.Aims: In this study,we will retrospectively analyze the clinical data of HCC patients who underwent radical surgery resection from our Hospital,to further investigate the impact of microvascular invasion on the prognosis of HCC,and to elucidate the role of microvascular invasion on the development and progression of HCC.The results from our study will provide the guidance to the management of HCC patients in clinic.Methods: The patient data of HCC which underwent radical surgery resection and confirmed by pathological examination from our hospital between years of 2010 to 2014 were analyzed retrospectively.According to the pathological report of whether associated with microvescular invasion or not,the patients were divided into two groups: microvascular invasion group and non-microvascular invasion group.The patients tumor-free survival time and overall survival time were statistically analyzed by Kaplan-Meier Survival curve and Log-Rank test.The other risk factors including tumor size,numbers,differentiation levels,and age were analyzed by unvaried analysis.Results: The data from total of 118 HCC patients were collected and analyzed.Microvascular invasion group was 28 cases and nonmicrovascular invasion group was 90 cases,respectively.Male was 94(79.6%)and female was 24(20.4%).The age range was 20-73 and average was 54 years old.HBV infection was 94 cases(79.6%)and HCV was 16 cases(13.6%).There was 8 cases without hepatitis virus infection(6.8%).There were 96 cases(81.3%)associated with liver cirrhosis and 22 cases(18.7%)without.There were 97 patients with one single lesion(82.2%)and 21 with multiple lesions(17.8%).According to the tumor size,mini-small HCC was 40 cases(33.9%),small HCC was 35 cases(29.7%),large HCC was 33 cases(28%),and extral large HCC was 10 cases(8.4%).There were 110 patients(93.2%)were Child-Pugh A and 8(6.8%)were B.There were 32 patients(27.1)were AFP > 400ul/L,31(26.3%)between 20 – 400ul/L,and 55(46.6%)AFP negative.According to the pathological ES grade,grades I/II were 87 cases(73.7%)and grades III/IV were 31 cases(26.2%).In addition,there were 47 cases(39.8%)enrolled in either TACE,RFA/MA/EI,or Medication therapy and 71 cases(60.2%)without any therapy post operatively.By the time of ending follow-up in December 2016,the average survival time was 29.46 ± 20.24 months in the microvascular invasion group with median survival time of 29 months,and the longest survival time was 72 months;The mean survival time was 37.89 ± 19.10 months in the non-microvascular invasion group with the median survival time of 50 months and the longest survival time was 78 months.The mean tumor-free survival time was 17.07 ± 18.96 months in microvascular invasion group,and 25.03 ± 20.51 months in non-microvascular invasion group.Kaplan-Meier curves showed the overall 1,3,5-years survival rate in comparison between microvascular invasion group and non-microvascular invasion group were 64% vs 86.7%,38% vs 68.7%,and 25% vs 35.7% respectively.P<0.05 in all 3 time points.While the 1,3,and 5 years tumor-free survival rate were 42.8% vs 63.3%,20.8% vs 37.3%,and 16.6% vs 25% between two groups,respectively.P<0.05 in all 3 time points too.Conclusions: Microvascular invasion is an important risk factor for the prognosis of HCC.The 1,3,and 5 years overall survival time and tumor-free survival time are all reduced significantly in the patients of HCC associated with microvascular invasion compared to that without microvascular invasion. |
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