Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis

Introduction: Microvascular invasion (MVI) of is generally considered to be an important prognostic factor for hepatocellular carcinoma (HCC) after operation, An accurate prediction of MVI before operation is helpful for clinical decision-making before operation. Material and methods: A retrospectiv...

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Main Authors: Yong Zhu He, Kun He, Rui Qin Huang, Ze Liang Wang, Shao Wei Ye, Li Wen Liu, Qi Jie Luo, Ze Min Hu
Format: Article
Jezik:English
Izdano: Elsevier 2020-11-01
Serija:Annals of Hepatology
Teme:
Online dostop:http://www.sciencedirect.com/science/article/pii/S1665268120300740
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author Yong Zhu He
Kun He
Rui Qin Huang
Ze Liang Wang
Shao Wei Ye
Li Wen Liu
Qi Jie Luo
Ze Min Hu
author_facet Yong Zhu He
Kun He
Rui Qin Huang
Ze Liang Wang
Shao Wei Ye
Li Wen Liu
Qi Jie Luo
Ze Min Hu
author_sort Yong Zhu He
collection DOAJ
description Introduction: Microvascular invasion (MVI) of is generally considered to be an important prognostic factor for hepatocellular carcinoma (HCC) after operation, An accurate prediction of MVI before operation is helpful for clinical decision-making before operation. Material and methods: A retrospective analysis of 227 cases of hepatocellular carcinoma patients after hepatectomy has been confirmed the pathological result whether there was MVI, and has been determined the independent risk factors of MVI. Based on these independent risk factors, we constructed a clinical scoring risk model for predicting MVI. Results: Among the 227 patients with HCC, 74 (34.6%) were MVI positive. Using receiver operating characteristic (ROC) curve and logistic regression model, we found that alpha-fetoprotein(AFP)≥158 ng/mL(odds ratio[OR] = 4.152,95% confidence interval [95%CI]:1.602∼10.760,p = 0.003), Des-γ-carboxy prothrombin (DCP)≥178mAU/mL(OR = 9.730,95%CI:3.392∼27.910,p < 0.001), circulating tumor cells (CTCs)≥3/3.2 ml(OR = 7.747,95%CI:3.019∼19.881,P < 0.001), maximum tumor diameter≥59 mm(OR = 3.467,95%CI:1.368∼8.669,p = 0.008) and tumor margin unsmoothness(OR = 0.235,95%CI:0.096∼0.573,p = 0.001) were independent risk factors for MVI, they predicted that the area under the curve of MVI was 0.752, 0.777, 0.857, 0.743 and 0.333, respectively. Based on these five independent risk factors, we constructed a clinical scoring risk model for predicting MVI. The model predicts that the area under the curve of MVI is 0.922, and its prevalence rate from 0 to 5 are 3.1%(1/32), 5.3%(4/76), 12.2%(5/41), 66.7%(20/30), 87.9%(29/33), 100%(15/15), respectively (P < 0.001). Conclusion: Based on AFP, DCP, CTC, maximum tumor diameter and tumor margin unsmoothness, we constructed a model to predict the risk of MVI clinical score, so as to make a more accurate individualized treatment plan before operation, which has important clinical significance and application prospect to improve the curative effect of HCC.
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spelling doaj.art-9c228dd1b71849c2b51bfa5f9a41b4712022-12-21T22:16:48ZengElsevierAnnals of Hepatology1665-26812020-11-01196654661Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysisYong Zhu He0Kun He1Rui Qin Huang2Ze Liang Wang3Shao Wei Ye4Li Wen Liu5Qi Jie Luo6Ze Min Hu7Department of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, China; Guangdong Medical University,Zhanjiang City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, China; Guangdong Medical University,Zhanjiang City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, China; Guangdong Medical University,Zhanjiang City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, ChinaDepartment of Hepatobiliary Surgery, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City, Guangdong Province, China; Corresponding author.Introduction: Microvascular invasion (MVI) of is generally considered to be an important prognostic factor for hepatocellular carcinoma (HCC) after operation, An accurate prediction of MVI before operation is helpful for clinical decision-making before operation. Material and methods: A retrospective analysis of 227 cases of hepatocellular carcinoma patients after hepatectomy has been confirmed the pathological result whether there was MVI, and has been determined the independent risk factors of MVI. Based on these independent risk factors, we constructed a clinical scoring risk model for predicting MVI. Results: Among the 227 patients with HCC, 74 (34.6%) were MVI positive. Using receiver operating characteristic (ROC) curve and logistic regression model, we found that alpha-fetoprotein(AFP)≥158 ng/mL(odds ratio[OR] = 4.152,95% confidence interval [95%CI]:1.602∼10.760,p = 0.003), Des-γ-carboxy prothrombin (DCP)≥178mAU/mL(OR = 9.730,95%CI:3.392∼27.910,p < 0.001), circulating tumor cells (CTCs)≥3/3.2 ml(OR = 7.747,95%CI:3.019∼19.881,P < 0.001), maximum tumor diameter≥59 mm(OR = 3.467,95%CI:1.368∼8.669,p = 0.008) and tumor margin unsmoothness(OR = 0.235,95%CI:0.096∼0.573,p = 0.001) were independent risk factors for MVI, they predicted that the area under the curve of MVI was 0.752, 0.777, 0.857, 0.743 and 0.333, respectively. Based on these five independent risk factors, we constructed a clinical scoring risk model for predicting MVI. The model predicts that the area under the curve of MVI is 0.922, and its prevalence rate from 0 to 5 are 3.1%(1/32), 5.3%(4/76), 12.2%(5/41), 66.7%(20/30), 87.9%(29/33), 100%(15/15), respectively (P < 0.001). Conclusion: Based on AFP, DCP, CTC, maximum tumor diameter and tumor margin unsmoothness, we constructed a model to predict the risk of MVI clinical score, so as to make a more accurate individualized treatment plan before operation, which has important clinical significance and application prospect to improve the curative effect of HCC.http://www.sciencedirect.com/science/article/pii/S1665268120300740Hepatocellular carcinomaMicrovascular invasionCirculating tumor cellsHepatectomy
spellingShingle Yong Zhu He
Kun He
Rui Qin Huang
Ze Liang Wang
Shao Wei Ye
Li Wen Liu
Qi Jie Luo
Ze Min Hu
Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
Annals of Hepatology
Hepatocellular carcinoma
Microvascular invasion
Circulating tumor cells
Hepatectomy
title Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
title_full Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
title_fullStr Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
title_full_unstemmed Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
title_short Preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion: a single-center retrospective analysis
title_sort preoperative evaluation and prediction of clinical scores for hepatocellular carcinoma microvascular invasion a single center retrospective analysis
topic Hepatocellular carcinoma
Microvascular invasion
Circulating tumor cells
Hepatectomy
url http://www.sciencedirect.com/science/article/pii/S1665268120300740
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