Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma.
Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma.
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DOI：
10.1186/1471-2407-14-38
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发表时间：
2014-01-24
期刊：
影响因子：
3.8
通讯作者：
Ji Y
中科院分区：
文献类型：
--
作者：
Du M;Chen L;Zhao J;Tian F;Zeng H;Tan Y;Sun H;Zhou J;Ji Y
小肝癌（small hepatocellular carcinoma，SHCC）是一种特殊类型的肝癌，肿瘤最大直径≤ 3 cm，长期预后良好。然而，小肝癌的预后因素仍存在争议。本研究的目的是阐明小肝癌的预测因素。研究人群包括2006年1月至2008年12月期间接受单次SHCC肝切除术的458例患者。分析患者的临床资料（包括年龄、性别、病毒感染、血清甲胎蛋白水平、肝硬化、包膜、边界）、组织病理学特征（包括分化程度、形态学亚型、微血管浸润、肿瘤浸润淋巴细胞（TIL）、周围肝组织炎性损伤分级和纤维化分期），以确定影响患者生存和微血管浸润的预后因素。男性384例（83.8%），女性74例（16.2%），中位年龄52岁。中位无进展生存期（PFS）和总生存期（OS）分别为53和54个月。421例小肝癌中91.9%（n = 421）为B型肝炎感染。446例术前有血清甲胎蛋白（AFP）水平记录的患者中，147例（33.0%）AFP水平≥ 200 μ g/ml; 280例术后有AFP水平记录的患者中，178例（63.8%）AFP水平≥ 20 μ g/ml。肝硬化411例（89.7%），肿瘤边界清楚434例（97.3%），包膜完整250例（55.6%）。83例患者（18.1%）发现MVI。在单变量分析中，发现MVI的存在与PFS和OS缩短之间存在显著相关性（分别为p = 0.012，0.028）。组织学分化与MVI有很强的相关性（p = 0.009），就MVI而言，组织学分化较差的患者更容易出现。MVI患者中，女性、G2或G3分化、术前或术后血清AFP水平≥ 200 μ g/ml、TIL ≥ 50/HPF者生存率较低。MVI是单个SHCC患者PFS和OS的独立不良预后因素。肿瘤组织分化程度与MVI密切相关。
Small hepatocellular carcinoma (SHCC) is a special type of hepatocellular carcinoma with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. However, the prognostic factors for SHCC remain controversial. The purpose of this study is to clarify the predictive factors of SHCC. The study population consisted of 458 patients underwent hepatectomy for single SHCC between January 2006 and December 2008. Clinical data (included age, gender, virus infection, serum alfa-fetoprotein level, cirrhosis, capsule, border), histopathologic features (included differentiation, morphology subtype, microvascular invasion, tumor infiltrative lymphocytes (TIL), inflammatory injury grade and fibrosis stage of surrounding liver), were evaluated to identify prognostic factors influencing SHCC patients’ survival and microvascular invasion. There were 384 males (83.8%) and 74 (16.2%) females with median ages of 52 years. The median progression-free survival (PFS) and overall survival (OS) durations were 53 and 54 months, respectively. About 91.9% (n = 421) SHCC were infected by Hepatitis B. One hundred forty-seven of the 446 (33.0%) patients with pre-operation serum AFP level record had serum alfa-fetoprotein (AFP) level ≥ 200 ug/ml and 178 of the 280 (63.8%) patients with post-operation serum AFP level record had AFP level ≥ 20 ug/ml. Liver cirrhosis was present in 411 cases (89.7%), while 434 (97.3%) tumors had clear border, and 250 (55.6%) tumors were encapsulated. MVI was identified in 83 patients (18.1%). In univariate analysis, a significant association between the presence of MVI and shortened PFS and OS was found (p = 0.012, 0.028, respectively). Histological differentiation had strong relationship with MVI (p = 0.009), in terms of MVI was more easily presented in patients with worse histological differentiation. In patients with MVI, worse survival was correlated with female patients, patients with G2 or G3 histological differentiation, pre-operation serum AFP level ≥ 200 ug/ml or post-operation serum AFP level ≥ 20 ug/ml, and TIL ≥ 50/HPF. MVI is an independent poorer prognostic factor for PFS and OS of single SHCC patients. Tumor histological differentiation was closely related with MVI.
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影响因子：
2.4
作者：
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