Microvascular invasion has limited clinical values in hepatocellular carcinoma patients at Barcelona Clinic Liver Cancer (BCLC) stages 0 or B.
Microvascular invasion has limited clinical values in hepatocellular carcinoma patients at Barcelona Clinic Liver Cancer (BCLC) stages 0 or B.
复制标题
巴塞罗那临床肝癌 (BCLC) 0 期或 B 期肝细胞癌患者的微血管侵犯临床价值有限
DOI：
10.1186/s12885-017-3050-x
复制
发表时间：
2017-01-17
期刊：
影响因子：
3.8
通讯作者：
Sun HC
中科院分区：
文献类型：
--
作者：
Huang C;Zhu XD;Ji Y;Ding GY;Shi GM;Shen YH;Zhou J;Fan J;Sun HC
背景微血管浸润（MVI）被认为是肝细胞癌（HCC）患者根治性切除术后预后不良的一个预后因素。目前还不清楚，但是，MVI是否可以提供预后信息的患者在一个特定的肿瘤stage. MethodsConcretiveHCC患者在2007年和2008年（发现队列）接受根治性切除术在这项回顾性研究。根据巴塞罗那临床肝癌（BCLC）分期系统对患者进行分层。在每个亚组中研究了MVI对总生存期（OS）和无复发生存期（RFS）的预后意义。MVI的临床意义进行了验证，在另一个队列的患者接受了根治性手术，在2006年（验证队列）。结果的1540例患者中的发现队列，389（25.3%）患者有可检测的MVI。BCLC 0期、A期和B期亚组的MVI发生率分别为12.4%、26.2%和34.4%。在单变量分析中，MVI与A期HCC患者的OS和RFS差相关（均P< 0.001），与0期患者的OS差相关（P= 0.028），与B期患者的RFS差相关（P= 0.039）。多因素分析显示，MVI是A期患者OS（HR = 1.431，95%CI，1.163- 1.761，P < 0.001）和RFS（HR = 1.400，95%CI，1.150- 1.705，P = 0.001）的独立危险因素，是B期患者RFS（P= 0.043）的独立危险因素。一个类似的临床意义的MVI被发现在validationcohol.ConclusionsMVI在BCLC 0期和B肝癌患者的预后价值有限。对于A期患者，MVI与患者生存率相关，可能有助于选择疾病复发风险高的患者。
BackgroundMicrovascular invasion (MVI) is recognized as a prognostic factor associated with poor outcome in hepatocellular carcinoma (HCC) patients after curative resection. It remains unclear, however, whether MVI can provide prognostic information for patients at a specific tumor stage.MethodsConsecutive HCC patients who underwent curative resection in years of 2007 and 2008 (discovery cohort) were enrolled in this retrospective study. Patients were stratified by the Barcelona Clinic Liver Cancer (BCLC) staging system. The prognostic significance of MVI for overall survival (OS) and recurrence-free survival (RFS) was studied in each subgroup. The clinical significance of MVI was validated in another cohort of patients underwent curative surgery in the year of 2006 (validation cohort).ResultsOf the 1540 patients in the discovery cohort, 389 (25.3%) patients had detectable MVI. Occurrence rates of MVI in the BCLC stage 0, A, and B subgroups were 12.4, 26.2, and 34.4%, respectively. In univariate analysis, MVI was associated with poor OS and RFS (P< 0.001 for both) in HCC patients at stage A, with poor OS in patients at stage 0 (P= 0.028), and with poor RFS at stage B (P= 0.039). In multivariate analysis, MVI was an independent risk factor for OS (HR = 1.431, 95% CI, 1.163–1.761,P< 0.001) and RFS (HR = 1.400, 95% CI, 1.150–1.705,P= 0.001) in patients at stage A; and an independent risk factor for RFS (P= 0.043) in patients at stage B. A similar clinical significance of MVI was found in the validation cohort.ConclusionsMVI has limited prognostic value for HCC patients at BCLC stages 0 and B. For those at stage A, MVI was associated with patient survival and may help to select patients with high risk of disease recurrence.