Prognostic value of a novel risk classification of microvascular invasion in patients with hepatocellular carcinoma after resection.
Prognostic value of a novel risk classification of microvascular invasion in patients with hepatocellular carcinoma after resection.
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肝细胞癌切除后微血管侵犯的新风险分类的预后价值
DOI：
10.18632/oncotarget.12547
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发表时间：
2017-01-17
期刊：
影响因子：
--
通讯作者：
Qiu Y
中科院分区：
文献类型：
--
作者：
Zhao H;Chen C;Fu X;Yan X;Jia W;Mao L;Jin H;Qiu Y
本研究旨在评估一种新的肝细胞癌（HCC）切除术后微血管浸润（MVI）风险分类的预后价值。共有295例连续肝癌患者接受肝切除术纳入我们的研究。根据浸润微血管数（≤5 vs >5）、浸润癌细胞数（≤ 50 vs >50）、浸润距肿瘤边缘距离（≤ 1cm vs > 1cm）三项指标评价MVI程度。根据MVI的3个危险因素将所有患者分为3组：无MVI组（n=180）、低MVI组（n=60）和高MVI组（n=55）。高MVI组的总生存率（OS）和无复发生存率（RFS）明显低于低MVI组和无MVI组（P<0.001和P=0.001; P<0.001和P=0.003）。多因素分析显示，高MVI、切除方式、ICG-R15和肿瘤大小是影响肝切除术后OS的危险因素。高MVI、手术切除方式和肿瘤大小是RFS的危险因素。在亚组分析中，无论肿瘤大小如何，低MVI组和非MVI组的OS和RFS率均优于高MVI组。在高MVI组中，解剖性肝切除术（n=28）的OS和RFS率优于非解剖性肝切除术（n=29）（P=0.012和P=0.002）。基于组织病理学特征的MVI风险分类对预测肝癌切除术后患者的预后有价值。
The present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) after resection. A total of 295 consecutive HCC patients underwent hepatectomy were included in our study. We evaluated the degree of MVI according to the following three features: the number of invaded microvessels (≤5 vs >5), the number of invading carcinoma cells (≤ 50 vs >50), the distance of invasion from tumor edge (≤1 cm vs >1 cm). All patients were divided into three groups according to the three risk factors of MVI: non-MVI group (n=180), low-MVI group (n=60) and high-MVI group (n=55). The overall survival (OS) and recurrence-free survival (RFS) rates of high-MVI group were significantly poorer than those of low-MVI and non-MVI groups (P<0.001 and P=0.001; P<0.001 and P=0.003). Multivariate analysis showed high-MVI, type of resection, ICG-R15 and tumor size were risk factors for OS after hepatectomy. High-MVI, type of resection and tumor size were risk factors for RFS. In subgroup analyses, the OS and RFS rates of low-MVI and non-MVI groups were better than high-MVI group regardless of tumor size. In high-MVI group, anatomical liver resection (n=28) showed better OS and RFS rates compared with non-anatomical liver resection (n=29) (P=0.012 and P=0.002). The novel risk classification of MVI based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy.