肝细胞癌微血管侵犯与临床病理指标的相关性  

Relationship between microvascular invasion and clinicalpathological characteristics in hepatocellular carcinoma patients

作　　者：金涛 李涛[2] 孙青[3] 郭亚迅 杨光升 李杰[2] JIN Tao;LI Tao;SUN Qing;GUO Ya-xun;YANG Guang-sheng;LI Jie(Qilu Medical College of Shandong University（Jinan 250012,China;Department of Hepatobiliary Surgery,3Department of Pathology,Qianfoshan Hospital of Shandong University（Jinan 250012,China)

机构地区：[1]山东大学齐鲁医学院,山东济南250012 [2]山东省千佛山医院肝胆外二科,山东济南250012 [3]山东省千佛山医院病理科,山东济南250012

出　　处：《中国现代普通外科进展》2018年第7期520-523,共4页Chinese Journal of Current Advances in General Surgery

基　　金：山东省医药卫生科技发展计划(2015ws0231)

摘　　要：目的:探讨肝细胞癌微血管侵犯与临床病理特征之间的相关性。方法 :选取2015年6月—2017年4月行手术治疗并且术后病理结果确诊为肝细胞癌的76例患者作为研究对象,根据是否存在微血管侵犯情况分为MVI组(n=50)和无MVI组(n=26)两组,采用单因素分析与Logistic多因素回归分析探讨MVI发生与肿瘤临床病理特征之间的相关性。结果:肝细胞癌患者中MVI发生率为65.79%(50/76),经单因素分析和Logistic多因素回归分析结果显示MVI的发生与肿瘤直径(P<0.001)、肿瘤病理分级(P<0.001)具有相关性,但与性别、年龄、肿瘤数目、AFP、Ki67阳性率、脉管内悬浮癌细胞数、胆管侵犯情况无明显相关性。结论:肝细胞癌微血管侵犯与肿瘤直径、肿瘤病理分级具有明显相关性。患者在术前行影像学检查明确肿瘤直径,有助于预测MVI的发生,从而对于肝癌患者手术方式的选择及术后综合治疗(靶向药物、TACE等)具有一定的临床指导意义。Objective： To explore the correlation between microvascular invasion and clinical- pathological characteristics in hepatocellutar carcinoma （HCC） patients. Methodst 76 HCC patients,treated and diagnosed by pathological examination during 2015.06-2017.04 in our department, were divided into MVI group and no MVI group according to the status of microvascular invasion. All clinical- pathological data were collected and analyzed by chi-square test and multiple logistic regression anal- ysis. Results： Of 76 consecutive HCC patients,50（65.79%）were founded to have a microvascular in- vasion. Tumor diameter （ X2= 14.148, P〈0.001 ）, tumor pathological grade （X2= 15.382, P〈0.001 ）were correlated with MVI. Logistic multivariate analysis showed that tumor diameter d≥3 cm and tumor pathological grade were independent risk factors for MVI. Conclusion： Tumor diameter and tumor pathological grade differentiation are independent risk factors for MVI. Determinations of tumor diame- ter by imaging examination and tumor pathological grade by liver biopsy preoperratively will provide us a novel clinical strategy of the prediction of the occurrence of MVI, so as to provide clinical guidances for determining surgical methods and postoperative comprehensive treatment in HCC patients.

关 键 词：肝细胞癌 微血管侵犯 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]