Background

Microvascular invasion (MVI) is an established prognosticator in hepatocellular carcinoma (HCC). Histopathological growth patterns (HGPs) classify the invasive margin of hepatic tumors, with superior survival observed for the desmoplastic HGP. Our aim was to investigate non-cirrhotic HCC in light of MVI and the HGP.

Methods

A retrospective cohort study was performed in resected non-cirrhotic HCC. MVI was assessed prospectively. The HGP was determined retrospectively, blinded, and according to guidelines. Overall and disease-free survival (OS, DFS) were evaluated by Kaplan–Meier and multivariable Cox regression.

Results

The HGP was determined in 155 eligible patients, 55 (35%) featured a desmoplastic HGP. MVI was observed in 92 (59%) and was uncorrelated with HGP (64% vs 57%, p = 0.42). On multivariable analysis, non-desmoplastic and MVI-positive were associated with an adjusted HR [95%CI] of 1.61 [0.98–2.65] and 3.22 [1.89–5.51] for OS, and 1.59 [1.05–2.41] and 2.30 [1.52–3.50] for DFS. Effect modification for OS existed between HGP and MVI (p < 0.01). Non-desmoplastic MVI-positive patients had a 5-year OS of 36% (HR: 5.21 [2.68–10.12]), compared to 60% for desmoplastic regardless of MVI (HR: 2.12 [1.08–4.18]), and 86% in non-desmoplastic MVI-negative.

Conclusion

HCCs in non-cirrhotic livers display HGPs which may be of prognostic importance, especially when combined with MVI.

中文翻译：

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组织病理学生长模式改变微血管侵袭对非肝硬化肝细胞癌的预后影响

背景

微血管浸润 (MVI) 是肝细胞癌 (HCC) 的既定预后指标。组织病理学生长模式 (HGP) 对肝肿瘤的侵袭性边缘进行分类，观察到促纤维增生性 HGP 的存活率更高。我们的目的是根据 MVI 和 HGP 研究非肝硬化 HCC。

方法

在切除的非肝硬化 HCC 中进行了一项回顾性队列研究。MVI 进行了前瞻性评估。HGP 是回顾性、盲法并根据指南确定的。通过 Kaplan-Meier 和多变量 Cox 回归评估总体和无病生存期（OS、DFS）。

结果

在 155 名符合条件的患者中确定了 HGP，其中 55 名（35%）具有促纤维增生性 HGP。在 92 例 (59%) 中观察到 MVI，并且与 HGP 无关（64% 对 57%，p = 0.42）。在多变量分析中，非促纤维增生和 MVI 阳性与 OS 的调整后 HR [95%CI] 1.61 [0.98–2.65] 和 3.22 [1.89–5.51] 和 1.59 [1.05–2.41] 和 2.30 [1.52] 相关–3.50] 对于 DFS。HGP 和 MVI 之间存在对 OS 的影响修正 (p < 0.01)。非促纤维增生性 MVI 阳性患者的 5 年 OS 为 36%（HR：5.21 [2.68-10.12]），而无论 MVI 为多少，促纤维化为 60%（HR：2.12 [1.08-4.18]）和 86%在非促纤维增生 MVI 阴性。

结论

非肝硬化肝脏中的 HCC 显示出可能具有预后意义的 HGP，尤其是与 MVI 结合时。