Influencing factors for microvascular invasion in patients with single hepatocellular carcinoma and their prognosis

Hu YueLei; Sun DaWei; Luo FeiXiang; Liu Huan; Lu: GuoYue

doi:10.3969/j.issn.1001-5256.2018.09.017

Issue 9

Sep. 2018

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2018 > 34(9): 1911-1916

PDF( 1736 KB)

Influencing factors for microvascular invasion in patients with single hepatocellular carcinoma and their prognosis

DOI: 10.3969/j.issn.1001-5256.2018.09.017

First Department of Hepatobiliary-pancreatic-splenic Surgery, The First Hospital of Jilin University

Received Date: 2018-03-13
Published Date: 2018-09-20

Abstract

Abstract

Objective To investigate the influencing factors for microvascular invasion (MVI) in patients with single hepatocellular carcinoma (SHCC) and their prognosis. Methods A retrospective analysis was performed for the clinical data of 138 patients with SHCC who were admitted to The First Hospital of Jilin University from January 2012 to December 2014 and underwent radical hepatectomy. The receiver operating characteristic curve was plotted based on neutrophil, platelet count (PLT) , fibrinogen, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, fibrinogen-albumin ratio, and presence or absence of MVI. The logistic regression model was used for univariate and multivariate analyses, and odds ratio (OR) and 95% confidence interval (CI) were used to evaluate association. The Kaplan-Meier method was used to calculate disease-free survival rate and plot survival curves of patients with or without MVI, and the log-rank test was used for survival analysis. Results The univariate analysis showed that sex (OR = 0. 400, 95% CI: 0. 162-0. 985, P = 0. 046) , tumor diameter (OR =5. 902, 95% CI: 2. 813-12. 382, P < 0. 001) , alpha-fetoprotein (AFP) (OR = 2. 635, 95% CI: 1. 286-5. 398, P = 0. 008) , neutrophil (OR = 3. 019, 95% CI: 1. 353-6. 736, P = 0. 007) , PLT (OR = 2. 255, 95% CI: 1. 116-4. 555, P = 0. 023) , fibrinogen (OR =3. 483, 95% CI: 1. 687-7. 190, P = 0. 001) , gamma-glutamyl transferase (OR = 2. 115, 95% CI: 1. 069-4. 182, P = 0. 031) , neutrophil-lymphocyte ratio (OR = 3. 662, 95% CI: 1. 803-7. 436, P < 0. 001) , platelet-lymphocyte ratio (OR = 3. 734, 95% CI: 1. 649-8. 455, P = 0. 002) , and fibrinogen-albumin ratio (OR = 3. 014, 95% CI: 1. 497-6. 070, P = 0. 002) were associated with MVI in patients with SHCC. The multivariate analysis indicated that tumor diameter (OR = 5. 423, 95% CI: 2. 555-11. 511, P < 0. 001) and AFP (OR = 2. 195, 95% CI: 1. 010-4. 774, P = 0. 047) were independent factors for MVI. The prognostic analysis showed that the 1-and3-year disease-free survival rates were 66. 4% and 52. 8%, respectively, in patients with MVI and 90. 6% and 71. 5%, respectively, in patients without MVI, and there were significant differences between these two groups of patients (χ2= 10. 929 and 4. 043, both P < 0. 05) .There was also a significant difference in disease-free survival curve between the two groups (χ2= 7. 860, P < 0. 05) . Conclusion Tumor diameter and preoperative AFP level are independent factors for MVI in patients with SHCC, and SHCC patients with MVI tend to have poor prognosis.
- carcinoma, hepatocellular,
- microvascular invasion,
- risk factors

FullText(HTML)

References(31)

References

[1]PERZ JF, ARMSTRONG GL, FARRINGTON LA, et al.The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide[J].J Hepatol, 2006, 45 (4) :529-538.

[2]FORNER A, LLOVET JM, BRUIX J.Hepatocellular carcinoma[J].Lancet, 2012, 379 (9822) :1245-1255.

[3]National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

[4]Chinese Society of Liver Cancer, Chinese Anti-Cancer Association;Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Pathology, Chinese Anti-Cancer Association, et al.Evidence-based practice guidelines for the standardized pathological diagnosis of primary liver cancer in China (2015 update) [J].J Clin Hepatol, 2015, 31 (6) :833-839. (in Chinese) 中国抗癌协会肝癌专业委员会, 中华医学会肝病学分会肝癌学组, 中国抗癌协会病理专业委员会, 等.原发性肝癌规范化病理诊断指南 (2015年版) [J].临床肝胆病杂志, 2015, 31 (6) :833-839.

[5]AHN SY, LEE JM, JOO I, et al.Prediction of microvascular invasion of hepatocellular carcinoma using gadoxetic acid-enhanced MR and (18) F-FDG PET/CT[J].Abdom Imaging, 2015, 40 (4) :843-851.

[6]HU H, ZHENG Q, HUANG Y, et al.A non-smooth tumor margin on preoperative imaging assesses microvascular invasion of hepatocellular carcinoma:A systematic review and meta-analysis[J].Sci Rep, 2017, 7 (1) :15375.

[7]REGINELLI A, VANZULLI A, SGRAZZUTTI C, et al.Vascular microinvasion from hepatocellular carcinoma:CT findings and pathologic correlation for the best therapeutic strategies[J].Med Oncol, 2017, 34 (5) :93.

[8]YANG C, WANG H, TANG Y, et al.ADC similarity predicts microvascular invasion of bifocal hepatocellular carcinoma[J].Abdom Radiol (NY) , 2018.[Epub ahead of print]

[9]HYUN SH, EO JS, SONG BI, et al.Preoperative prediction of microvascular invasion of hepatocellular carcinoma using 18F-FDGPET/CT:A multicenter retrospective cohort study[J].Eur J Nucl Med Mol Imaging, 2018, 45 (5) :720-726.

[10]EGUCHI S, TAKATSUKI M, HIDAKA M, et al.Predictor for histological microvascular invasion of hepatocellular carcinoma:A lesson from 229 consecutive cases of curative liver resection[J].World J Surg, 2010, 34 (5) :1034-1038.

[11]FAN LF, ZHAO WC, YANG N, et al.Alpha-fetoprotein:The predictor of microvascular invasion in solitary small hepatocellular carcinoma and criterion for anatomic or non-anatomic hepatic resection[J].Hepatogastroenterology, 2013, 60 (124) :825-836.

[12]SHIRABE K, ITOH S, YOSHIZUMI T, et al.The predictors of microvascular invasion in candidates for liver transplantation with hepatocellular carcinoma-with special reference to the serum levels of des-gamma-carboxy prothrombin[J].J Surg Oncol, 2007, 95 (3) :235-240.

[13]POTN, CAUCHY F, ALBUQUERQUE M, et al.Performance of PIVKA-II for early hepatocellular carcinoma diagnosis and prediction of microvascular invasion[J].J Hepatol, 2015, 62 (4) :848-854.

[14]REN Y, POON RT, TSUI HT, et al.Interleukin-8 serum levels in patients with hepatocellular carcinoma:Correlations with clinicopathological features and prognosis[J].Clin Cancer Res, 2003, 9 (16 Pt 1) :5996-6001.

[15]CAO GL, CAI Q, LI YA, et al.Risk factors analysis and prognosis of the microvascular invasion of hepatocellular carcinoma[J].Chin J Dig Surg, 2017, 16 (10) :1048-1052. (in Chinese) 曹国良, 蔡庆, 李幼安, 等.肝细胞癌微血管侵犯的危险因素分析及预后[J].中华消化外科杂志, 2017, 16 (10) :1048-1052.

[16]YU Y, SONG J, ZHANG R, et al.Preoperative neutrophil-tolymphocyte ratio and tumor-related factors to predict microvascular invasion in patients with hepatocellular carcinoma[J].Oncotarget, 2017, 8 (45) :79722-79730.

[17]BRUIX J, SHERMAN M;Practice Guidelines Committee, American Association for the Study of Liver Diseases.Management of hepatocellular carcinoma[J].Hepatology, 2005, 42 (5) :1208-1236.

[18]RODRGUEZ-PERLVAREZ M, LUONG TV, ANDREANA L, et al.A systematic review of microvascular invasion in hepatocellular carcinoma:Diagnostic and prognostic variability[J].Ann Surg Oncol, 2013, 20 (1) :325-339.

[19]ZHAO H, HUA Y, LU Z, et al.Prognostic value and preoperative predictors of microvascular invasion in solitary hepatocellular carcinoma≤5 cm without macrovascular invasion[J].Oncotarget, 2017, 8 (37) :61203-61214.

[20]RENZULLI M, BROCCHI S, CUCCHETTI A, et al.Can current preoperative imaging be used to detect microvascular invasion of hepatocellular carcinoma?[J].Radiology, 2016, 279 (2) :432-442.

[21]ZHENG J, SEIER K, GONEN M, et al.Utility of serum inflammatory markers for predicting microvascular invasion and survival for patients with hepatocellular carcinoma[J].Ann Surg Oncol, 2017, 24 (12) :3706-3714.

[22]IMURA S, TERAOKU H, YOSHIKAWA M, et al.Potential predictive factors for microvascular invasion in hepatocellular carcinoma classified within the Milan criteria[J].Int J Clin Oncol, 2018, 23 (1) :98-103.

[23]HUSSAIN SP, HARRIS CC.Inflammation and cancer:An ancient link with novel potentials[J].Int J Cancer, 2007, 121 (11) :2373-2380.

[24]OUYANG B, QIU YL, WANG YX, et al.Study of TSGF, AFPand GGT in the diagnosis of primary hepatic carcinoma[J].Shenzhen J Integr Tradit Chin West Med, 2016, 26 (5) :6-8. (in Chinese) 欧阳彬, 丘燕丽, 汪云霞.TSGF、AFP、GGT联合诊断原发性肝癌的临床价值[J].深圳中西医结合杂志, 2016, 26 (5) :6-8.

[25]WEI X, LI N, LI S, et al.Hepatitis B virus infection and active replication promote the formation of vascular invasion in hepatocellular carcinoma[J].BMC Cancer, 2017, 17 (1) :304.

[26]ZHENG B, ZHU YJ, WANG HY, et al.Gender disparity in hepatocellular carcinoma (HCC) :Multiple underlying mechanisms[J].Sci China Life Sci, 2017, 60 (6) :575-584.

[27]RUGGIERI A, BARBATI C, MALORNI W.Cellular and molecular mechanisms involved in hepatocellular carcinoma gender disparity[J].Int J Cancer, 2010, 127 (3) :499-504.

[28]BAI SL, YANG PH, LI J, et al.Effect of microvascular invasion on postoperative long-term prognosis of small and large hepatocellular carcinoma[J/CD].Chin J Hepatic Surg:Electronic Edition, 2017, 6 (3) :207-211. (in Chinese) 白石磊, 杨平华, 李俊, 等.微血管侵犯对小肝细胞癌和大肝细胞癌术后远期预后的影响[J/CD].中华肝脏外科手术学电子杂志, 2017, 6 (3) :207-211.

[29]SHEN J, LI C, YAN L, et al.Short-and long-term outcomes between young and older HCC patients exceeding the milan criteria after hepatectomy[J].Ann Hepatol, 2018, 17 (1) :134-143.

[30]HUANG C, ZHU XD, JI Y, et al.Microvascular invasion has limited clinical values in hepatocellular carcinoma patients at Barcelona Clinic Liver Cancer (BCLC) stages 0 or B[J].BMC Cancer, 2017, 17 (1) :58.

[31]CHENG Y, JIA WD, XING SG, et al.Clinical efficacy of anatomic liver resection in the treatment of hepatocellular carcinoma with microvascular invasion[J].Chin J Dig Surg, 2017, 16 (2) :144-150. (in Chinese) 程亚, 荚卫东, 邢松歌, 等.解剖性肝切除术治疗合并微血管侵犯肝细胞癌的临床疗效[J].中华消化外科杂志, 2017, 16 (2) :144-150.

Relative Articles

[1]	Zhiguo LI, Xun MA, Yongan YE, Xianzhao YANG. Regulatory effect of Kangxian Yiai Prescription in a rat model of precancerous lesions of liver cancer： A study based on the mTOR/HIF-1α/VEGF signaling pathway[J]. Journal of Clinical Hepatology, 2024, 40(10): 2049-2054. doi: 10.12449/JCH241019
[2]	Haimei GUAN, Kan ZHANG, Weiyu CHEN, Guobao LI, Yangling ZENG, Riyun ZHANG, Tianwen WANG, Baohua XIE, Dewen MAO. Mechanism of action and potential value of the IRE1α/TRAF2/JNK pathway in the progression of acute liver failure[J]. Journal of Clinical Hepatology, 2024, 40(6): 1281-1288. doi: 10.12449/JCH240633
[3]	Hepatology｜Intestinal IL-33 promotes microbiota-derived trimethylamine N-oxide synthesis and drives metabolic dysfunction-associated steatotic liver disease progression by exerting dual regulation on HIF-1α[J]. Journal of Clinical Hepatology, 2024, 40(9): 1766-1766. doi: 10.12449/JCH2409.gwqkjpwzjj1
[4]	Xing YANG, Shudi LI, Jiangkai LIU, Zhen WANG, Suling LI. Current research status of traditional Chinese medicine in the prevention and treatment of hepatocellular carcinoma by regulating the JAK/STAT signaling pathway[J]. Journal of Clinical Hepatology, 2023, 39(11): 2718-2729. doi: 10.3969/j.issn.1001-5256.2023.11.030
[5]	Cheng MA, Hui YANG. Role of the nuclear factor erythroid 2-related factor 2/heme oxygenase-1 signaling pathway in alcoholic liver disease[J]. Journal of Clinical Hepatology, 2023, 39(7): 1708-1713. doi: 10.3969/j.issn.1001-5256.2023.07.028
[6]	Hua ZHANG, Xuanxuan KOU, Jingxin DENG, Jiangang ZHANG. Regulatory role of hypoxia－inducible factor－1α/Yes－associated protein in nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2023, 39(9): 2191-2197. doi: 10.3969/j.issn.1001-5256.2023.09.024
[7]	Rui SONG, Jing LI, Hongju YANG, Minyue LI, Jing YOU. Role of signal transducer and activator of transcription 1 in regulation of Treg/Th17 balance in hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2022, 38(11): 2627-2631. doi: 10.3969/j.issn.1001-5256.2022.11.038
[8]	Jinjin ZHAO, Haiguang ZHANG, Feifei CUI, Lei WANG, Qingjiang MO, Luyang JIAO. Effect of hypoxia-inducible factor-1α on stemness and epirubicin sensitivity of HepG2 hepatoma cells[J]. Journal of Clinical Hepatology, 2021, 37(2): 354-357. doi: 10.3969/j.issn.1001-5256.2021.02.021
[9]	Zheng Yang, Wang JiaRu, Liu LuLu, Wang JiaHui, Zhao TieJian. Molecular mechanism of the anti-liver fibrosis effect of curcumol: An analysis based on the TLR4/NF-κB signaling pathway[J]. Journal of Clinical Hepatology, 2020, 36(7): 1508-1513. doi: 10.3969/j.issn.1001-5256.2020.07.013
[10]	Zhao DongKang, Luo WeiWei, Yu ShuiPing. Role of the Wnt signaling pathway in the development and progression of liver fibrosis[J]. Journal of Clinical Hepatology, 2018, 34(11): 2415-2419. doi: 10.3969/j.issn.1001-5256.2018.11.033
[11]	Zhang Xu, Liu Ping, Mu YongPing. Relationship between the Notch signaling pathway and the development and progression of liver fibrosis[J]. Journal of Clinical Hepatology, 2018, 34(1): 181-183. doi: 10.3969/j.issn.1001-5256.2018.01.039
[12]	Ju Di, Li JingTao, Han Man, Wei HaiLiang, Yan ShuGuang, Li Mi, Shi XiaoYan, Chang ZhanJie. Research advances in the influence of hepatic stellate cells on precancerous lesions of liver cirrhosis and hepatocellular carcinoma via the TGFβ1-PI3K/AKT signaling pathway[J]. Journal of Clinical Hepatology, 2018, 34(1): 192-194. doi: 10.3969/j.issn.1001-5256.2018.01.042
[13]	Peng Qin, Zhao ShenJun, Li Wu. Research advances in signaling pathways involved in the development of hepatic fibrosis[J]. Journal of Clinical Hepatology, 2017, 33(5): 954-958. doi: 10.3969/j.issn.1001-5256.2017.05.035
[14]	Wang Li, Shi Wei, Xue Jun, Pan CuiRan, Yao Min, Yao DengFu. Regulatory effect of abnormal expression of hypoxia- inducible factor- 1α on angiogenesis in hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2017, 33(2): 369-374. doi: 10.3969/j.issn.1001-5256.2017.02.037
[15]	Zhang ChaoYa, Zhao XiangXuan, Lu ZaiMing, Guo QiYong. Research advances in sorafenib- induced apoptotic signaling pathways in liver cancer cells[J]. Journal of Clinical Hepatology, 2016, 32(4): 816-820. doi: 10.3969/j.issn.1001-5256.2016.04.048
[16]	Zhou XueLing, Yu ShuiPing. Role of Wnt signaling pathway in progression of liver cirrhosis[J]. Journal of Clinical Hepatology, 2015, 31(9): 1540-1542. doi: 10.3969/j.issn.1001-5256.2015.09.045
[17]	Pan Jin, Ju Jian. Current perspectives on the JAK/STAT signaling pathway and its activating factors in liver fibrosis[J]. Journal of Clinical Hepatology, 2013, 29(5): 393-396.
[18]	Zheng Yan, Zhang ChunQing, Wang QiZhi, Huang HaiYan, Wang ZhiNa, Wei Yuan, Xu AnTao. Differential expression of OPN, VEGF-A, and HIF-1α and its clinical significance in hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2013, 29(1): 58-61.
[19]	Gou ZePeng, Wang DeSheng, Zhou Liang, Zhu PuLi, Zhang Yong, Sun Wei. The research progress of STAT3 on the regulation of hepatocellular carcinoma invasion and metastasis[J]. Journal of Clinical Hepatology, 2012, 28(4): 308-311.

Supplements(0)

Cited By

Cited by

Periodical cited type(5)

1.	马玉洁，姬群英. 原发性胆汁性肝硬化诊治进展. 大医生. 2022(22): 98-101 .
2.	党富涛，唐映梅. 自身抗体在原发性胆汁性胆管炎中的诊断及预后价值. 临床肝胆病杂志. 2020(05): 1164-1166 . 本站查看
3.	吴蓉，冷爱民. 原发性胆汁性胆管炎合并自身免疫性溶血性贫血1例报告. 临床肝胆病杂志. 2020(12): 2795-2797 . 本站查看
4.	杨剑. 胆管阻塞患者PTCD治疗后肝损伤、炎症和胆汁淤积的预后影响因素及护理策略. 国际护理学杂志. 2020(20): 3696-3700 .
5.	赵敏，李勤光，卓传尚. 乙型病毒性肝炎与原发性胆汁性胆管炎患者血清抗线粒体抗体M2亚型表达的特征分析. 现代检验医学杂志. 2020(06): 16-20 .

Other cited types(0)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (2082) PDF downloads(367)

Influencing factors for microvascular invasion in patients with single hepatocellular carcinoma and their prognosis

DOI: 10.3969/j.issn.1001-5256.2018.09.017