Department of Radiation Oncology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
World J Surg Oncol. 2024 May 8;22(1):125. doi: 10.1186/s12957-024-03399-1.
To investigate the correlation between microinvasion and various features of hepatocellular carcinoma (HCC), and to clarify the microinvasion distance from visible HCC lesions to subclinical lesions, so as to provide clinical basis for the expandable boundary of clinical target volume (CTV) from gross tumor volume (GTV) in the radiotherapy of HCC.
HCC patients underwent hepatectomy of liver cancer in our hospital between July 2019 and November 2021 were enrolled. Data on various features and tumor microinvasion distance were collected. The distribution characteristics of microinvasion distance were analyzed to investigate its potential correlation with various features. Tumor size compared between radiographic and pathologic samples was analyzed to clarify the application of pathologic microinvasion to identify subclinical lesions of radiographic imaging.
The average microinvasion distance was 0.6 mm, with 95% patients exhibiting microinvasion distance less than 3.0 mm, and the maximum microinvasion distance was 4.0 mm. A significant correlation was found between microinvasion and liver cirrhosis (P = 0.036), serum albumin level (P = 0.049). Multivariate logistic regression analysis revealed that HCC patients with cirrhosis had a significantly lower risk of microinvasion (OR = 0.09, 95%CI = 0.02 ~ 0.50, P = 0.006). Tumor size was overestimated by 1.6 mm (95%CI=-12.8 ~ 16.0 mm) on radiographic size compared to pathologic size, with a mean %Δsize of 2.96% (95%CI=-0.57%~6.50%). The %Δsize ranged from - 29.03% to 34.78%.
CTV expanding by 5.4 mm from radiographic GTV could include all pathologic microinvasive lesions in the radiotherapy of HCC. Liver cirrhosis was correlated with microinvasion and were independent predictive factor of microinvasion in HCC.
为了探讨肝癌（HCC）的微浸润与各种特征之间的相关性，并明确从肉眼可见的 HCC 病变到临床前病变的微浸润距离，以便为 HCC 放射治疗中从大体肿瘤体积（GTV）扩展临床靶区（CTV）的边界提供临床依据。
纳入 2019 年 7 月至 2021 年 11 月在我院行肝癌肝切除术的 HCC 患者。收集了各种特征和肿瘤微浸润距离的数据。分析微浸润距离的分布特征，探讨其与各种特征的潜在相关性。分析影像学与病理样本之间肿瘤大小的比较，阐明病理微浸润对识别影像学临床前病变的应用。
平均微浸润距离为 0.6mm，95%的患者微浸润距离小于 3.0mm，最大微浸润距离为 4.0mm。微浸润与肝硬化（P=0.036）、血清白蛋白水平（P=0.049）有显著相关性。多因素 logistic 回归分析显示，肝硬化的 HCC 患者微浸润的风险显著降低（OR=0.09，95%CI=0.020.50，P=0.006）。与病理大小相比，影像学大小上的肿瘤大小高估了 1.6mm（95%CI=-12.816.0mm），平均 %Δsize 为 2.96%（95%CI=-0.57%6.50%）。%Δsize 范围为-29.03%34.78%。
从 HCC 放射治疗的影像学 GTV 向外扩展 5.4mm 可包括所有病理微浸润病变。肝硬化与微浸润相关，是 HCC 微浸润的独立预测因素。
