摘要
目的 探究微血管侵犯(MVI)的发生及与肝细胞癌(HCC)患者预后之间的联系.方法 收集从 2015年 7 月至 2022 年 6 月共 1633 例(深圳市人民医院 305 例、南昌大学第一附属医院 591 例、南昌大学第二附属医院 578 例、中山市人民医院 159 例)行手术治疗的HCC患者的临床资料.明确HCC患者预后以及MVI的共同独立影响因素并探究MVI在各个影响因素不同分组中的发生率以及对患者预后的影响.结果 ROC曲线显示相比其他预后因素,MVI与患者预后关系最密切.研究显示甲胎蛋白(AFP)、肝硬化、肿瘤直径、淋巴细胞-单核细胞比(LMR)是MVI和HCC患者预后的共同影响因素.分组后发现肝硬化、AFP阳性(AFP≥20 ng/ml)、肿瘤直径>50 mm、LMR≤3.4 的患者中MVI发生率明显高于其他组患者,并且四组中MVI阳性患者均表现出更高的早期复发率以及病死率(P<0.05).结论 通过预后因素可以有效预测HCC患者肝切除术后MVI的发生以及MVI与预后之间的联系.
Abstract
Objective To investigate the occurrence of microvascular invasion(MVI)and its relationship with the prognosis of hepatocellular carcinoma(HCC)patients.Methods The clinical data of 1633 HCC patients who underwent surgical treatment from July 2015 to June 2022(305 from Shenzhen People's Hospital,591 from the First Affiliated Hospital of Nanchang University,578 from the Second Affiliated Hospital of Nanchang University,and 159 from Zhongshan City People's Hospital)was collected.The common independent influencing factors for prognosis and MVI of HCC patients were identified,and the incidence of MVI in different subgroups of influencing factors and its impact on patient prognosis were explored.Results The ROC curve showed that compared to other prognostic factors,MVI had the closest relationship with patient prognosis.Research showed that alpha fetoprotein(AFP),liver cirrhosis,tumor diameter and Lymphocyte-monocyte ratio(LMR)are common prognostic factors for MVI and HCC patients.After grouping,it was found that the incidence of MVI was significantly higher in patients with liver AFP-positive(AFP≥20 ng/ml),tumor diameter>50 mm,and LMR≤3.4 than patients in other groups,and MVI-positive patients in all four groups showed higher early recurrence rates and mortality rates(P<0.05).Conclusion Prognostic factors can effectively predict the occurrence of MVI and the relationship between MVI and prognosis in HCC patients after hepatectomy.
基金项目
广东省基础与应用基础研究基金(2021A1515220059)
国家科技期刊平台
NSTL
万方数据