Donghia Rossella, Carr Brian Irving, Yilmaz Sezai
National Institute of Gastroenterology - IRCCS "Saverio de Bellis", Castellana Grotte, Italy.
Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.
Oncology. 2025 Apr 8:1-11. doi: 10.1159/000545636.
Maximum tumor diameter (MTD) is one of the key aggressiveness features of hepatocellular carcinoma (HCC). However, the clinical associations and causes of large size HCC are not well understood. The aim was to compare small and large MTD (≤/>6 cm) HCCs with respect to clinical associations.
MTD ≤/> 6 cm HCCs were compared by clinical characteristics and analyzed through logistical regression models, as well as Cox proportional hazard models for death, on clinical parameters.
Patients with larger HCCs had more portal vein thrombosis (PVT) and tumor multifocality, higher AST, ALKP and GGT levels and lower albumin levels. A logistic regression model of MTD (≤/>6 cm) showed the highest risk for PVT and platelet-lymphocyte ratio (PLR) >150, while albumin and female gender were protective. The combination of male gender, PLR >150, plus PVT had an odds ratio of 12.124. In Cox proportional hazard models, the highest hazard ratio for death was for PVT, and only albumin was significantly protective. PVT plus low albumin had a hazard ratio of 4.254.
PVT, albumin, PLR, and gender were significant for ≤/>6 cm MTD. PVT and albumin were significant for survival.
最大肿瘤直径（MTD）是肝细胞癌（HCC）的关键侵袭性特征之一。然而，大尺寸HCC的临床关联和病因尚未完全明确。本研究旨在比较小MTD（≤6 cm）和大MTD（>6 cm）HCC的临床关联。
根据临床特征对MTD≤/ >6 cm的HCC进行比较，并通过逻辑回归模型以及针对临床参数的死亡的Cox比例风险模型进行分析。
大尺寸HCC患者的门静脉血栓形成（PVT）和肿瘤多灶性更多，AST、ALKP和GGT水平更高，白蛋白水平更低。MTD（≤/ >6 cm）的逻辑回归模型显示，PVT和血小板淋巴细胞比率（PLR）>150的风险最高，而白蛋白和女性性别具有保护作用。男性、PLR>150加上PVT的组合的优势比为12.124。在Cox比例风险模型中，死亡的最高风险比是PVT，只有白蛋白具有显著的保护作用。PVT加上低白蛋白的风险比为4.254。
PVT、白蛋白、PLR和性别对于MTD≤/ >6 cm具有重要意义。PVT和白蛋白对生存具有重要意义。
