The predictive values of intratumoral arteries and tumoralmorphological classification on microvascular invasion in patients with hepatocellular carcinoma

Abstract

Objective To investigate the predictive values of preoperative radiological features-intratumoral arteries and tumoral morphological classification on microvascular invasion (MVI) and on prognosis in patients with hepatocellular carcinoma (HCC). Methods A total of 220 consecutive HCC patients who underwent curative hepatectomy at Nanjing Drum Tower Hospital from January 2008 to December 2014 were retrospectively analyzed. The predictive values of preoperative radiological features and clinical data on MVI were analyzed by the univariate analysis and multivariate logistic regression methods. The prognosis of HCC patients was analyzed by the Kaplan-Meier survival analysis and the Cox proportional hazards models. Results Univariate analysis and multivariate logistic regression showed intratumoral arteries and tumoral morphological classification using preoperative CT[called the radiological predictorsof microvascular invasion (RPMVI)] to be independent predictors of MVI. The AUROC for RPMVI inpredicting MVI was 0.830 (95% CI, 0.769~0.891, P 5 cm, RPMVI, MVI and non-anatomical liver resection to be independent risk factorsof overall survival (OS), while tumor size >5 cm, RPMVI, MVI and non-anatomical liver resection to be independent risk factor sofre currence-free survival (RFS). The 1-, 3-, and 5-year OS rates were 83.3%, 61.7%, and 40.1% in patients with RPMVI and 97.1%, 76.5%, and 69.6% in patients without RPMVI (P<0.05), respectively.The 1-, 3-, and 5-year RFS rates were 61.9%, 36.9%, and 28.4% in patients with RPMVI and 81.6%, 61.9%, and 52.2% in patients without RPMVI (P<0.05), respectively. Conclusions RPMVI is a novel radiological marker that accurately predicted histological MVI in HCC patients preoperatively. Similar to MVI, RPMVI was found to be an independent risk factor for prognosisin HCC patients, and it may provide the important information for surgical treatment planning in HCC patients. Key words: Intratumoral arteries; Tumor morphological classification; Hepatocellular carcinoma; Microvascular invasion; Prediction; Prognosis