肝癌合并微血管侵犯的相关因素分析

目的:探讨肝癌合并微血管侵犯(microvascular invasion,MVI)的临床危险因素,为肝癌术前预测、诊断治疗以及判断预后提供依据。方法:回顾性分析165例确诊为肝癌患者的临床、影像以及病例资料,依据术后病理报告有无微血管侵犯分为MVI阳性组(42例)和MVI阴性组(123例)。比较分析两组间年龄、性别、乙型肝炎病毒感染情况、甲胎蛋白(alpha fetoprotein,AFP)水平(AFP>400 ng/mL、AFP≤400 ng/mL)、肝功能指标、肿瘤大小(>5 cm、≤5 cm)、肿瘤数目、包膜是否完整、有无瘤内动脉形成、肿瘤边缘是否光滑、有无瘤内组织坏死以及肿瘤分化程度与MVI形成的关系。结果:单因素分析结果显示,MVI阳性组与MVI阴性组相比,AFP水平、白蛋白水平、肿瘤最大直径、存在瘤内动脉以及瘤内坏死有统计学差异(P<0.05)。将其纳入多因素Logistic回归分析,两组间AFP水平、肿瘤最大直径、存在瘤内动脉以及瘤内坏死有统计学差异(P<0.05)。结论:AFP水平、肿瘤最大直径、存在瘤内动脉以及瘤内坏死是MVI发生的独立危险因素。

Analysis of risk factors of hepatocellular carcinoma complicated with microvascular invasion

Objective:To analyze the relevant risk factors for microvascular invasion (MVI) in patients with hepatocellular carcinoma to provide basis for preoperative prediction,diagnosis and treatment and prognosis.Methods:The clinical, imaging and case data of 165 patients diagnosed with hepatocellular carcinoma were retrospectively analyzed, and they were divided into positive MVI group (42 cases) and negative MVI group (123 cases) according to the postoperative pathological report with or without microvascular invasion.The relationships of age,gender,hepatitis B virus infection,alpha fetoprotein (AFP) level (AFP＞400 ng/mL,AFP≤400 ng/mL),liver function indexes,tumor size (＞5 cm,≤5 cm),the number of tumors,the integrity of the capsule,the formation of intratumoral arteries,the smoothness of tumor margins,the presence or absence of intratumoral tissue necrosis,degree of tumor differentiation with the formation of MVI were compared between the two groups.Results:The univariate analysis result showed that AFP level,albumin level,tumor diameter,artery and necrosis within the tumor was statistically significant between positive MVI group and negative MVI group (P＜0.05),and in the multi-factor Logistic regression analysis,AFP level,tumor diameter,artery and necrosis within the tumor was statistically significant (P＜0.05).Conclusion:AFP level,tumor diameter,artery and necrosis within the tumor are the independent risk factors for the formation of MVI.