HBV相关肝细胞肝癌微脉管癌栓局部免疫微环境对患者术后预后的影响

目的:探讨HBV相关肝细胞肝癌(hepatocellular carcinoma,HCC)微脉管侵犯(microvascular invasion,MVI)癌栓局部免疫微环境对患者预后的影响.方法:入选2012年3月至2013年11月初诊HBV相关HCC患者.所有入选病例均有HBV感染史且无其他肝脏疾病基础,患者接受单...

Effect of immune microenvironment of microvascular invasion on prognosis of patients with HBV-related hepatocellular carcinoma

Objective: To explore the prognostic value of MVI in HBV related HCC and explore the immune-related prognostic criteria of MVI by using digital slides.Methods: A total of 175 HBV related HCC Cases first time diagnosed are collected prospectively. Information including age, gender, the diameter of the tumor, BCLC stage, AFP level and MVI. Based on ensuring the prognostic value of MVI, the expressions of CD3, CD4, CD8, CD20 and PD-1 in thrombus and the hotspot in nearby liver collected from 53 cases were successfully transformed into data in digital slides. Predictable benchmarks would be found in integrating the immune data with clinic follow-up information. Results: The difference between MVI and the non-MVI group is significant in RFS analysis, no matter it is univariate (p=0.016) or multivariate (p=0.032). Based on that, the expressions of CD4 and CD8 in MVI thrombi, in this case, have diagnostic significance (p=0.031 and 0.036) and their cutoffs are established successfully (0.208 and 0.465, respectively). According to the cut-off obtained, the survival analysis indicates that those cases expressed CD4+ and CD8+ T cells higher in thrombus in MVI show a better RFS compared to the lower ones (p=0.003&0.035). Conclusions: MVI is an independent prognostic factor of HBV related HCC. The CD4+/CD8+T cells infiltrating in its thrombi correlated with the postpone of recurrence after the primary operation probably.