显微镜下门静脉侵犯是肝切除术后肝细胞癌患者预后的有力预测指标。

Microscopic portal vein invasion is a powerful predictor of prognosis in patients with hepatocellular carcinoma who have undergone liver resection.

机构信息

Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Surgery, Liver Transplantation Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

J Surg Oncol. 2021 Jan;123(1):222-235. doi: 10.1002/jso.26260. Epub 2020 Oct 20.

DOI:10.1002/jso.26260

PMID:33084068

Abstract

BACKGROUND AND OBJECTIVES

A recent study proposed simple classifications of microscopic vascular invasion (MVI): microscopic portal vein invasion (MPVI) and microvessel invasion (MI). We aim to validate these classifications of MVI.

METHODS

This retrospective study consecutively enrolled 514 Barcelona Clinic Liver Cancer stage 0, A, and B naïve hepatocellular carcinoma patients who underwent liver resection in our institution from 2011 to 2017.

RESULTS

Among these 514 patients, 240 patients were classified as having no MVI at all (designated as no vascular invasion, NVI), 157 patients were classified as having MI only, and 117 patients were classified as having MPVI. The 5-year overall survival (OS) rate in the MI-only group was 83.3%, which was not significantly different from that of the NVI group (87.2%), p = .20. Using NVI as a reference, multivariate analysis showed that MI-only is not an independent variable associated with OS. The 5-year OS in the MPVI group was 59.2%, which was significantly lower than those for MI-only (p < .001) and NVI groups (p < .001). Using NVI as a reference, multivariate analysis showed that MPVI is an independent variable associated with OS (HR, 3.12; 95% CI, 1.80-5.40; p < .001).

CONCLUSIONS

The results of this study validate the simple MVI classifications to be clinically useful.

摘要

背景与目的

最近的一项研究提出了微血管侵犯（MVI）的简单分类：显微镜下门静脉侵犯（MPVI）和微血管侵犯（MI）。我们旨在验证这些 MVI 分类的有效性。

方法

这项回顾性研究连续纳入了 514 名在我院接受治疗的巴塞罗那临床肝癌（BCLC）0 期、A 期和 B 期初治的肝细胞癌患者，他们均接受了肝切除术，研究时间为 2011 年至 2017 年。

结果

在这 514 名患者中，240 名患者被归类为没有任何 MVI（指定为无血管侵犯，NVI），157 名患者被归类为仅存在 MI，117 名患者被归类为存在 MPVI。MI 组的 5 年总生存率（OS）为 83.3%，与 NVI 组（87.2%）无显著差异（p=0.20）。使用 NVI 作为参考，多变量分析显示 MI 仅是与 OS 无关的独立变量。MPVI 组的 5 年 OS 为 59.2%，显著低于 MI 组（p<0.001）和 NVI 组（p<0.001）。使用 NVI 作为参考，多变量分析显示 MPVI 是与 OS 相关的独立变量（HR，3.12；95%CI，1.80-5.40；p<0.001）。