| Part ? Study on the Effect of "7" on the Detection Rate of MVI in liver cancer specimensObjective:MVI occured in the surrounding area near the tumor.Hence ,cancer of the liver specimens based "7" point baseline which came up with?Evidence-based practice guidelines for standardized pathological diagnosis of parimary liver cancer inChina)) (2015 edition) emphasized to sample in the surrounding area near the tumor.In order to evaluate the effect of the method on the detection rate of MVI, the incidence of MVI in the conventional specimens of liver cancer and the incidence of MVI in "7"baseline standard specimens were analyzed and compared.Methods:The patients with primary hepatocellular carcinoma (HCC) who underwentradical surgery from 2011 to 2015 were retrospectively studied in the control group (n=117 cases).The patients with HCC between January 2016 and December 2016 which required for the?guidelines?were taken as experimental group,in which liver cancer specimens were sampled based on the "7" baseline standards.Classification of MVI:M0:without MVI;M1(low risk group):the number of MVI?5 and MVI occurred in the area ?1cm from the tumor;M2(high risk group):the number of MVI > 5 or MVI occurred in the area > 1cm from the tumor.Continuous variables were analyzed with t test,and categorical variables were compared with ?2 or Fisher's exact test.Results:There were no significant differences between the two groups in sex age,cirrhosis, capsule of tumor, positive HBsAg, tumor differentiation, preoperative serum AFP and tumor number(P > 0.05).In order to make these two groups of baseline characteristics be similar.The diameter of the tumor was divided into two layers(<5cm and ?5cm)because of there being significant difference between the two groups (P<0.05).The detection rate of MVI in the control group was 55.5% (M1 was 35.0% and M2 was 20.5%) and in the experimental group was 62.0%(Mlwas 37.9%,M2was 24.1%).When the tumor diameter <5cm and ?5cm, the incidence of M1 and M2 was not significantly different between the two groups (P = 0.376,P=0.629).Conclusion(s):The detection rate of MVI sampling based on the "7" baseline standards was 62.0% (Ml was 37.9% and M2 was 24.1%),which was slightly higher than that of control group. However, there was no significant difference in the detection rate of M1 and M2 between the two groups.Part II Study on the relationship between the histological classification of MVI and clinicopathological featuresObjective:Patients with MVI classified based on the number of MVI and MVI occurred in the distant area nera the tumor,and analyze the relationship between the classification of MVI and clinicopathological features,Screening of which with predictable significance for MVI.Methods: 175 patients with primary HCC from the part I were included in the experimental study,and completed the clinical and pathological datas.MVI classified as :M0(n=74):without MVI;M1(n=63):the number of MVI?5 and MVI occurred in the area ?1cm from the tumor;M2(n=38):the number of MVI>5 or MVI occurred in the area > 1cm from the tumor.Continuous variables were analyzed with One-way analysis of variance or Kruskal-Wallis H test ,and categorical variables were compared with ?2 or Fisher's exact test.Single factor meaningful variables were entered into multivariate logistic regression analysis.Results:When the age < 54 years, petients of HCC have a increased risk of M2 (P =0.008).There was no statistically difference in sex, cirrhosis, HbsAg and the number of tumors between the MVI groups(P> 0.05).However,the M0, M1, M2 groups of tumor diameter, capsule, satellite nodules, preoperative serum AFP levels, and tumor differentiation were significantly statistically different.Multivariate logistic regression analysis found that tumor diameter> 3cm,preoperative serum AFP ?100ng/ml were independent predictors of Ml,and Patients with age?54 years, tumor diameter> 3cm,capsule is not complete or no capsule, poor tumor differentiation, preoperative serum AFP ?100ng / ml were independent predictors of M2.Conclusions:There was no statistically difference in sex, cirrhosis, HbsAg and the number of tumors between the MVI groups (P> 0.05). Tumor diameter > 3 cm,preoperative serum AFP?100ng/ml were independent predictors of Ml,and Patients with age ?54 years, tumor diameter> 3cm, capsule is not complete or no capsule,poor tumor differentiation, preoperative serum AFP ?100ng / ml were independent predictors of M2.Part ? Study of relationship betweenMVI and early recurrence of HCCObjective:Here,we analyzed the effect of the classification of MVI,gross vascular invasion and other clinical pathological parameters on early recurrence within 6 months,and explored the risk factors of early recurrence of HCC after hepatectomy,which provided a reference for postoperative adjuvant therapy.Methods:Collected patients with primary HCC who were followed up within six months after operation and accomplished their classification of MVI,gross vascular invasion, tumor capsule, tumor differentiation, preoperative serum AFP levels and other clinicopathological features.Followed up of patients with recurrence within six months after surgery .A variety of statistical methods wered used to analysis of the correlation between the clinical pathological parameters and early recurrence of HCC,and P <0.05 indicated statistical significance.Results: 102 patients with primary HCC were included in the experimental study,and 26 patients (25.5%) had recurrence in six months and 76 patients had no recurrence(74.5%) after surgery. HCC patients with M0, M1, M2 and gross vascular invasion groups of early recurrence were significantly different (P = 0.000).The half-year recurrence rate of M2 group and gross vascular invasion group were statistically different from MO and M1 groups.Howere,there were no difference between MOgroup and M1 group,which had lower recurrence rates,and so did M2 group and gross vascular invasion group,which had higher recurrence rates.Univariate and multivariate logistic regression analysis showed that M2 or gross vascular invasion, serum AFP100ng/ml,poor tumor differentiation were independent risk factors for early recurrence of HCC.Conclusion:The half-year recurrence rate of M2 group was statistically different from MO and M1 groups. Howere, there were no difference between MO group and M1 group, and so did M2 group and gross vascular invasion group. Patient of HCC with M2 or gross vascular invasion, serum AFP ?100ng/ml, poor tumor differentiation were independent risk factors for early recurrence. |
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