Zhao Hui, Chen Chuang, Fu Xu, Yan Xiaopeng, Jia Wenjun, Mao Liang, Jin Huihan, Qiu Yudong
Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi, Jiangsu, China.
Oncotarget. 2017 Jan 17;8(3):5474-5486. doi: 10.18632/oncotarget.12547.
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.
本研究旨在评估一种新的微血管侵犯（MVI）风险分类对肝细胞癌（HCC）切除术后的预后价值。
本研究纳入了295例连续接受肝切除术的HCC患者。我们根据以下三个特征评估MVI程度：微血管侵犯数量（≤5个对>5个）、侵袭癌细胞数量（≤50个对>50个）、肿瘤边缘侵袭距离（≤1 cm对>1 cm）。
根据MVI的三个危险因素，所有患者分为三组：无MVI组（n = 180）、低MVI组（n = 60）和高MVI组（n = 55）。高MVI组的总生存期（OS）和无复发生存期（RFS）率显著低于低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、切除类型、吲哚菁绿滞留率15分钟（ICG-R15）和肿瘤大小是肝切除术后OS的危险因素。高MVI、切除类型和肿瘤大小是RFS的危险因素。在亚组分析中，无论肿瘤大小如何，低MVI组和无MVI组的OS和RFS率均优于高MVI组。在高MVI组中，解剖性肝切除（n = 28）的OS和RFS率优于非解剖性肝切除（n = 29）（P = 0.012和P = 0.002）。
基于组织病理学特征的MVI新风险分类对预测HCC患者肝切除术后的预后具有重要价值。
