Analysis Of The Clinical Value Of TACE After Liver Cancer Surgery And The Predictive Value Of Ki67 In Liver Cancer Surgery

Objective: To retrospectively analyze the difference of disease-free survival(DFS)between patients with hepatitis B-related small hepatocellular carcinoma(≤ 5 cm)treated with adjuvant transcatheter arterial chemoembolization(TACE)and those treated with surgery alone,and to explore the effect of adjuvant TACE on early recurrence of small hepatocellular carcinoma.At the same time,we retrospectively analyzed the correlation between Ki67 expression and related clinical data in the pathological data of patients receiving radical surgery for hepatocellular carcinoma in our hospital,as well as the difference between Ki67 expression and tumor-free survival of patients with hepatocellular carcinoma,and evaluated the value of Ki67 in the prognosis of patients with hepatocellular carcinoma.Methods: In the study of the effect of adjuvant TACE therapy on early recurrence in patients with small hepatocellular carcinoma,the clinical data of 137 patients with hepatitis B-related small hepatocellular carcinoma who received surgical treatment in Liaoning cancer hospital from January 2016 to June 2020 were collected,and the patients were divided into TACE group and surgical group according to whether they received postoperative adjuvant TACE therapy,and the baseline data of the two groups were compared.Kaplan-Meier method was used to draw the disease-free survival curve of the two groups,and Log-rank test was used to compare the difference of disease-free survival between the two groups.The clinicopathological data of the cases were analyzed by univariate analysis,and the significant indexes were included in the multivariate survival analysis.In the study of Ki67 and prognosis of liver cancer,the general clinical data of all patients with liver cancer who received radical surgery from January 2020 to June 2020 were collected,and the patients were divided into low expression group and high expression group according to the expression level of Ki67,and the differences of clinicopathological characteristics between the two groups were analyzed.Univariate Logistic regression analysis was used to analyze the relationship between Ki67 expression and early recurrence of HCC,and Kaplan-Meier method was used to draw the disease-free survival curve of the two groups,and Log-rank test was used to compare the difference of disease-free survival between the two groups,so as to evaluate the prognostic value of Ki67 expression in patients with HCC after operation.Results: 1.In the study of the effect of adjuvant TACE therapy on early recurrence in patients with small hepatocellular carcinoma,the baseline data of the two groups were not statistically different,and the two groups were comparable.The 1-,2-year disease-free survival rates were 80.4%,66.1% in Tace group and 87.1%,70.1% in operation group respectively.There was no significant difference between the two sets of data(Log Rank P = 0.370).Univariate analysis showed that MVI(P = 0.036)and tumor size(P = 0.001)were associated with disease-free survival.Multivariate analysis showed that MVI(P = 0.036)and tumor size(P = 0.001)were independent risk factors for early recurrence of HBV-related SHCC.2.In the study of Ki67 and prognosis of HCC,the expression of Ki67 was strongly correlated with the degree of tumor differentiation(P = 0.013)and the number of tumors(P = 0.002),but not with other clinical characteristics.Univariate Logistic regression analysis showed that there was a significant difference in the expression of Ki67 between patients with early recurrence and patients without recurrence(P = 0.004).The disease-free survival curve was drawn,and there was a difference in diseasefree survival rate between the two groups by Log-rank test(Log Rank P = 0.002).Conclusion: 1.Postoperative adjuvant TACE did not reduce the early recurrence rate in patients with HBV-related small HCC(≤ 5 cm).2.Tumor size and microvascular invasion are independent risk factors for early recurrence of HBV-related small hepatocellular carcinoma.3.The expression of Ki67 has a strong correlation with the degree of tumor differentiation and the number of tumors.Ki67 may be an indicator to predict the biological behavior of liver malignant tumors.4.The expression of Ki67 is helpful to predict the prognosis of hepatocellular carcinoma and provide a reference for clinical treatment.