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

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.