Department of Hepatobiliary and Pancreatic Surgery, The Third Affiliated Hospital of Soochow University, Jiangsu, China.
Comput Math Methods Med. 2022 Mar 21;2022:8195512. doi: 10.1155/2022/8195512. eCollection 2022.
To forecast the onset of microvascular invasion (MVI) in patients with hepatoma by evaluating the preoperative aspartate aminotransferase-to-platelet ratio index (APRI), alpha-fetoprotein (AFP), neutrophil-to-lymphocyte ratio (NLR), and other clinicopathological data.
In this study, we retrospectively analysed the clinical data of 62 patients who received radical surgery for hepa toma from 2019 to 2021. Patients were separated into the MVI-negative group and the MVI-positive group according to the postoperative pathological diagnosis. The relationships between MVI and NLR, APRI, AFP, tumor size, and other clinical data were assessed using the univariate analysis, receiver operating characteristic (ROC) curve, least absolute shrinkage and selection operator (LASSO) analysis, and logistic analysis.
The ROC curve determined that the cutoff values of NLR, platelet-to-lymphocyte ratio (PLR), and APRI were 1.520, 98, and 0.275, respectively. The univariate analysis showed that the MVI-positive result was associated with five factors: tumor size ( = 10.620, = 0.001), AFP ( = 10.524, = 0.001), Edmondson grade ( = 20.736, < 0.001), NLR ( = 8.744, = 0.003), and APRI ( = 4.849, = 0.028). The LASSO analysis indicated that the risk factors were the number of tumors, PLR, APRI, NLR, AFP, Edmondson grade, and tumor size. The multivariate logistic regression analysis showed that NLR ≥ 1.520 (OR 11.119, = 0.006), APRI ≥ 0.275 (OR 12.515, = 0.009), AFP ≥ 200 g/mL (OR 7.823, = 0.016), and tumor size > 3 cm (OR 7.689, = 0.022) were independent risk factors for MVI in patients with hepatoma.
Preoperative NLR, APRI, AFP, and tumor size are reliable indicators for predicting the appearance of MVI in patients with hepatoma and are of great value in making detailed and reliable treatment protocols for these patients before surgery.
通过评估术前天门冬氨酸氨基转移酶与血小板比值指数（APRI）、甲胎蛋白（AFP）、中性粒细胞与淋巴细胞比值（NLR）及其他临床病理数据，预测肝癌患者微血管侵犯（MVI）的发生。
本研究回顾性分析了 2019 年至 2021 年期间 62 例行根治性手术的肝癌患者的临床资料。根据术后病理诊断，患者分为 MVI 阴性组和 MVI 阳性组。采用单因素分析、受试者工作特征（ROC）曲线、最小绝对值收缩选择算子（LASSO）分析和逻辑回归分析评估 MVI 与 NLR、APRI、AFP、肿瘤大小等临床资料的关系。
ROC 曲线确定 NLR、血小板与淋巴细胞比值（PLR）和 APRI 的截断值分别为 1.520、98 和 0.275。单因素分析显示，MVI 阳性结果与 5 个因素相关：肿瘤大小（ = 10.620， = 0.001）、AFP（ = 10.524， = 0.001）、Edmondson 分级（ = 20.736， < 0.001）、NLR（ = 8.744， = 0.003）和 APRI（ = 4.849， = 0.028）。LASSO 分析表明，危险因素包括肿瘤数量、PLR、APRI、NLR、AFP、Edmondson 分级和肿瘤大小。多因素逻辑回归分析显示，NLR≥1.520（OR 11.119， = 0.006）、APRI≥0.275（OR 12.515， = 0.009）、AFP≥200 g/ml（OR 7.823， = 0.016）和肿瘤大小＞3 cm（OR 7.689， = 0.022）是肝癌患者 MVI 的独立危险因素。
术前 NLR、APRI、AFP 和肿瘤大小是预测肝癌患者 MVI 发生的可靠指标，对术前为这些患者制定详细可靠的治疗方案具有重要价值。
