微血管侵犯对肝癌合并门静脉癌栓患者术后的影响：一项回顾性研究。

The Effect of Microvascular Invasion on Hepatocellular Carcinoma With Portal Vein Tumor Thrombus After Hepatectomy: A Retrospective Study.

机构信息

Department of Hepatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.

Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.

出版信息

Cancer Control. 2024 Jan-Dec;31:10732748241265257. doi: 10.1177/10732748241265257.

DOI:10.1177/10732748241265257

PMID:39048098

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11403670/

Abstract

BACKGROUND

There is no report resolving whether microvascular invasion (MVI) affects the prognosis of hepatectomy for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). The present study aimed to investigate the effect of MVI on HCC with PVTT after hepatectomy.

METHODS

362 HCC patients with PVTT were included in this retrospective study. Diagnostic criteria of PVTT in HCC patients were based on typical preoperative radiological features on imaging studies. The log-rank test was utilized to differentiate overall survival (OS) and recurrence-free survival (RFS) rates between the two groups. Univariate and multivariate Cox proportional hazard regression was utilized to detect independent factors.

RESULTS

PVTT without MVI accounted for 12.2% (n = 44). PVTT without MVI groups was significantly superior to PVTT with MVI groups in OS (the median survival = 27.1 months vs 13.7 months) and RFS (the median survival = 6.4 months vs 4.1 months). The 1-, 3-, and 5-year OS rates (65.5%, 36.8%, 21.7% vs 53.5%, 18.7%, 10.1%, = .014) and RFS rates (47.0%, 29.7%, 19.2% vs 28.7%, 12.2%, 6.9%, = .005) were significant different between two groups. Multivariate analysis showed that MVI was an independent risk factor for OS (hazard ratio (HR) = 1.482; -value = .045) and RFS (HR = 1.601; -value = .009).

CONCLUSIONS

MVI was an independent prognostic factor closely linked to tumor recurrence and poorer clinical outcomes for HCC patients with PVTT after hepatectomy. MVI should be included in current PVTT systems to supplement to the PVTT type.

摘要

背景

目前尚无研究阐明微血管侵犯（MVI）是否影响伴有门静脉癌栓（PVTT）的肝细胞癌（HCC）患者行肝切除术后的预后。本研究旨在探讨 MVI 对伴有 PVTT 的 HCC 患者行肝切除术后的影响。

方法

本回顾性研究纳入了 362 例伴有 PVTT 的 HCC 患者。HCC 患者的 PVTT 诊断标准基于影像学检查的典型术前影像学特征。采用对数秩检验比较两组患者的总生存（OS）率和无复发生存（RFS）率。采用单因素和多因素 Cox 比例风险回归分析检测独立因素。

结果

无 MVI 的 PVTT 占 12.2%（n=44）。无 MVI 的 PVTT 组在 OS（中位生存时间=27.1 个月比 13.7 个月）和 RFS（中位生存时间=6.4 个月比 4.1 个月）方面显著优于有 MVI 的 PVTT 组。两组的 1 年、3 年和 5 年 OS 率（65.5%、36.8%、21.7%比 53.5%、18.7%、10.1%， =.014）和 RFS 率（47.0%、29.7%、19.2%比 28.7%、12.2%、6.9%， =.005）差异有统计学意义。多因素分析显示，MVI 是 OS（风险比（HR）=1.482；P 值=.045）和 RFS（HR=1.601；P 值=.009）的独立危险因素。