Study On Clinicopathological Characteristics Of Microvascular Invasion In Hepatocellular Carcinoma

Hepatocellular carcinoma(HCC)is a highly aggressive malignant tumor.At present,the more promising method is radical surgery and liver transplantation.However,the recurrence rate of hepatocellular carcinoma is still high..At present,microvascular invasion is considered as an independent risk factor for early recurrence and metastasis of hepatocellular carcinoma,and it is also an important index for screening liver transplant recipients.Some studies have shown that increasing the margin of resection during liver resection can obtain a better prognosis,but due to the limitation of tumor size,location,cirrhosis,and remaining liver volume,sufficient margin of margin cannot always be achieved during surgery.It has been reported in the literature that MVI invasion can penetrate the capsule and infiltrate into blood vessels 1 cm outside the tumor margin.When formulating a surgical plan for such patients,under the premise of ensuring that the remaining liver volume is sufficient,the margin of resection should be expanded to strive for anatomical liver resection.In summary,predicting MVI is of clinical significance.OBJECTIVE: The purpose of this study was to retrospectively analyze the clinical data of patients undergoing anatomical hepatectomy for hepatocellular carcinoma due to hepatocellular carcinoma in the Hepatobiliary Surgery of the First Affiliated Hospital of China Medical University,and to explore the clinical relevance of microvascular invasion(MVI)of liver cancer.And pathological characteristics provide theoretical basis for preoperative prediction of microvascular invasion of liver cancer.Materials and Methods: The clinical,pathological and imaging data of patients undergoing anatomical liver resection and undergoing postoperative pathological diagnosis of primary hepatocellular carcinoma were retrospectively analyzed from 2017 to 2019 in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of China Medical University.According to postoperative pathological returns,they were divided into MVI group and non-MVI group.The correlation between gender,age,preoperative liver function,preoperative alpha-fetoprotein level(AFP),hepatitis virus infection,tumor size,number of tumors,degree of differentiation of liver cancer and other factors were analyzed.Based on the results of this study,try to predict MVI before surgery,so as to better specify the surgical plan for liver resection of hepatocellular carcinoma.Results: There were no significant differences in age,gender,preoperative liver function,blood type,and hepatitis virus infection between the two groups(P> 0.05).The serum AFP level,CA199,and tumor size in the MVI group were significantly larger than those in the non-MVI group(P <0.05),and the degree of tissue differentiation in the MVI group was significantly lower than that in the MVI-free group(P <0.05).In addition,by analyzing the magnetic resonance imaging(MRI)of the preoperative lesions in the two groups of patients,it was found that the incidence of pseudocapsules in liver cancer lesions in the MVI group was significantly less than that in the non-MVI group(P <0.05).The tumor edges in the group were more smooth(P <0.05).Logistic regression analysis of the above risk factors showed that in the MVI group and the non-MVI group,the degree of tumor differentiation and the maximum tumor diameter were independent risk factors for the occurrence of microvascular invasion in liver cancer(P <0.05).Conclusions: 1.There were no significant differences in gender,age,hepatitis B virus infection,liver cirrhosis,liver function,number of tumors,and Child grade between the MVI and non-MVI groups.2.Compared with the non-MVI group,the tumor tissue in the MVI group had a lower degree of differentiation,higher levels of AFP and CA199,less smooth tumor edges,lower incidence of pseudocapsules,and larger tumor diameters.The degree of tumor differentiation and the maximum diameter of the tumor are independent risk factors for the occurrence of microvascular invasion of liver cancer.Therefore,for hepatocellular carcinoma with larger tumor diameter and lower differentiation,close follow-up should be performed to detect early postoperative recurrence and improve Prognosis.