影响肝细胞癌患者肿瘤微血管侵犯的多因素分析*

doi:10.3969/j.issn.1672-5069.2024.01.024

摘要/Abstract

摘要： 目的探讨影响肝细胞癌(HCC)患者微血管侵犯(MVI)的危险因素。方法 2018年3月～2022年3月我院诊治的HCC患者206例,均接受MRI检查和肝段或肝叶切除术治疗,术后组织病理学检查诊断MVI。应用单因素和多因素Logistic回归分析影响HCC患者MVI形成的独立危险因素。结果在206例HCC患者中,组织病理学检查发现MVI 50例(24.3%);MVI组肿瘤直径≥5 cm和肿瘤细胞低分化分别为56.0%和58.0%,均显著高于非MVI组的32.7%和35.3%(P<0.05),而两组血清AFP水平400 ng/mL、Child-Pugh B级和肿瘤包膜是否完整占比无显著性差异(P>0.05);多因素非条件Logistic回归模型分析果显示,肿瘤≥5 cm和肿瘤细胞呈低分化为HCC患者并发MVI的独立危险因素(OR=1.166,OR=1.141,均P<0.05)。结论肿瘤直径大和细胞低分化为影响HCC患者并发MVI的独立危险因素,术前进行影像学检查了解肿瘤大小或可初步判断HCC患者是否存在MVI而进行必要的治疗准备可能有助于制定合理的手术方案。

关键词: 肝细胞癌, 磁共振成像, 肝叶切除术, 微血管侵犯, 多因素Logistic回归分析

Abstract: Objective The aim of this study was to investigate the risk factors for microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Methods 206 patients with HCC were encountered in our hospital between March 2018 and March 2022, and all underwent MRI and hepatectomy. The MVI was diagnosed by histopathology. The univariate and multivariate Logistic regression analysis were applied to predict the existence of MVI in patients with HCC. Results Out of the 206 patients with HCC, the MVI was found in 50 cases (24.3%); there were no significant differences as respect to serum AFP levels, Child-Pugh classes and the tumor envelope intact or not between patients with and without MVI(P>0.05), while the percentages of tumor diameter ≥5 cm and low tumor cell differentiation in patients with MVI were 56.0% and 58.0%, both much higher than 32.7% and 35.3% (P<0.05) in patients without MVI; the multivariate Logistic regression analysis showed that the tumor diameter ≥5 cm and low tumor cell differentiation were the independent risk factors for the existence of MVI in patients with HCC (OR=1.166, OR=1.141, bot P<0.05). Conclusion The large tumor and low differentiation of tumor cells are the independent risk factors of MVI happening in patients with HCC, and the preoperative imaging could help determine the size of tumors, and thus make the therapeutic strategy.

Key words: Hepatoma, Magnetic resonance imaging, Hepatectomy, Microvascular invasion, Multivariate Logistic regression analysis

许梁, 梁宏伟, 杜圣, 黄爱娜, 张涛. 影响肝细胞癌患者肿瘤微血管侵犯的多因素分析^*[J]. 实用肝脏病杂志, 2024, 27(1): 92-95.

Xu Liang, Liang Hongwei, Du Sheng, et al. Risk factors for microvascular invasion in patients with hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2024, 27(1): 92-95.

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影响肝细胞癌患者肿瘤微血管侵犯的多因素分析^*

Risk factors for microvascular invasion in patients with hepatocellular carcinoma

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