A preoperative prediction model of microvascular invasion in hepatocellular carcinoma

Objective To analyze the risk factors of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC), and to establish a preoperative prediction model for MVI. Methods The clinical data of 159 patients with HCC from the First Hospital of Jilin University treated from January 2012 to December 2014 were retrospectively analyzed. There were 128 males and 31 females. Univariate and multivariate logistic regression analysis of factors influencing the presence of MVI in HCC patients were carried out. Independent risk factors were scored based on the β values of multivariate analysis. Receiver operating characteristics (ROC) curves were used to evaluate the predictive value of the scores for the risk factor for MVI. Results Univariate and multivariate logistic regression analyses showed that age ≥ 60 years (OR=0.263, 95% CI: 0.112 ~ 0.614), tumor diameter ≥5 cm (OR=3.902, 95% CI: 1.784 ~ 8.583), neutrophil to lymphocyte ratio (NLR) ≥ 1.83 (OR=2.414, 95% CI: 1.065~5.472) and platelet to lymphocyte ratio (PLR) ≥72.30 (OR=2.578, 95% CI: 1.068~6.223) were the influencing factors of MVI in patients with HCC (P<0.05). The preoperative prediction model of MVI was established using the MVI independent risk factor scores. The area under the ROC curve was 0.793 (95% CI: 0.723~ 0.862). The optimal cutoff value for the presence of MVI was 2.75 points, and the sensitivity was 0.72 and the specificity was 0.78 . The MVI positive rates of patients with risk scores of 0 to 1.5, 2.0 to 3.5, and 4.0 to 5.0 were 18.6%, 42.9%, and 78.3%, respectively. Conclusion Age, tumor diameter, NLR, and PLR were independent factors influencing MVI in patients with HCC. The preoperative model based on the independent risk factor scores can be used to predict the presence of MVI in HCC patients. Key words: Carcinoma, hepatocellular; Age factors; Microvascular invasion; Tumor diameter; Inflammatory marker