术前纤维蛋白原水平对肝细胞癌微血管侵犯及预后的影响

目的 探讨术前血清纤维蛋白原(fibrinogen,FIB)水平与肝细胞癌(hepatocellular carcinoma,HCC)微血管侵犯(microvascular invasion,MVI)的关系及FIB对根治切除术后HCC预后的影响.方法 回顾性分析福建医科大学孟超肝胆医院2015年1月至2019年4月行根...

Effect of preoperative fibrinogen level on microvascular invasion and prognosis of hepatocellular carcinoma

Objective To investigate the relationship between preoperative serum fibrinogen (FIB) level and microvascular invasion (MVI) in hepatocellular carcinoma (HCC) and effect of FIB on prognosis of HCC patients after radical hepatectomy. Methods The clinical data of 566 HCC patients who underwent radical hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University between Jan. 2015 and Apr. 2019 were retrospectively analyzed. The ability of FIB to predict MVI was shown by drawing the receiver operating characteristic (ROC) curve, and then the optimal cut-off value of FIB for predicting MVI was determined. According to cut-off value, patients were divided into low FIB group and high FIB group. Chi-square test was used to analyze the relationship between FIB and clinicopathological factors, Kaplan-Meier method was used to analyze HCC patients’ survival, Log-rank method was used to the test difference, and univariate and multivariate Cox regression analysis were used to evaluate the influencing factors of HCC prognosis. Results The optimal cut-off value of MVI predicted by preoperative FIB was 2.7 g/L. The positive rate of MVI in high FIB group (FIB>2.7 g/L) was higher than that in the low FIB group (FIB≤2.7 g/L) [64.0%(183/283) vs 47.0%(133/283), P<0.01]. The recurrence-free survival (RFS) in high FIB groups was significantly lower than that in low FIB group (1-year, 2-year and 3-year RFS were 68.6%, 47.0%, 35.4%, and 71.5%, 60.0%, 48.3%, respectively, P<0.05), but there was no statistical significant difference in overall survival (OS) between the two groups (P=0.14). Univariate and multivariate Cox regression analysis showed that FIB was a risk factor for RFS (HR=1.37, 95%CI 1.07~1.75,P=0.011), and MVI was an independent risk factor for HCC prognosis in patients with HCC (HR=6.65, 95%CI2.78~15.87, P<0.001). Conclusion This study suggests that the preoperative fibrinogen level is positively correlated with MVI and negatively correlated with RFS after radical resection hepatectomy for HCC.