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肝癌伴微血管侵犯的相关因素研究
Study on the Related Factors of Hepatocellular Carcinoma with Microvascular Invasion

DOI: 10.12677/jcpm.2024.31023, PP. 152-159

Keywords: 微血管侵犯,肝细胞癌,肝切除术,危险因素,预后
Microvascular Invasion
, Hepatocellular Carcinoma, Liver Resection, Risk Factors, Prognosis

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Abstract:

肝癌是严重危害人类健康的重大疾病,到2025年,肝癌患者新增将突破100万。肝细胞癌(hepatocellular carcinoma, HCC)是肝癌中最常见的一种,约占85%。我国人口基数较大,是肝癌发病重灾区,发病率在恶性肿瘤中处于第四位,2022年新增肝癌患者为39.9万例,每年因为肝癌而导致的死亡人数约是全世界的一半,在我国的恶性肿瘤致死率排名中,位居第二位。目前最好的根治方法仍然是手术切除,但是肝细胞癌的预后还是不佳。肿瘤的分化程度、数目、大小、有无转移等都会影响到肝癌的预后。在临床上,越来越多的研究表明,手术后经病理确认伴有微血管侵犯(Microvascular invasion, MVI)的患者,其复发率明显升高,生存率明显下降。因此,肝癌的恶性程度及预后,除了与肿瘤大小、数量、远处转移等因素有关外,还与肝癌是否伴有MVI密切相关。因此,判断肝细胞癌是否发生MVI并及时采取适当的干预措施是提高肝细胞癌患者生存率的关键。
Liver cancer is a major disease that seriously endangers human health. By 2025, the increase of liver cancer patients will exceed 1 million. HCC (hepatocellular carcinoma, HCC) is one of the most common in liver cancer, about 85%. China has a large population base, is the worst-hit area of liver cancer, the incidence of malignant tumors in the fourth place, in 2022, the number of new liver cancer patients for 399,000 cases, the annual number of deaths caused by liver cancer is about half of the world, in China’s malignant tumor fatality rate ranking second. Surgical resection is still the best option, but the prognosis for hepatocellular carcinoma remains poor. The degree of differentiation, number, size and metastasis of the tumor will affect the prognosis of liver cancer. Clinically, more and more studies have shown that the recurrence rate of patients with microvascular invasion (MVI) confirmed by pathology after surgery is significantly increased, and the survival rate is significantly decreased. The malignant degree and prognosis of HCC, therefore, in addition to and, distant metastasis, tumor size, number and related factors, but also closely related with liver cancer if accompanied by MVI. Therefore, to determine whether MVI occurs in hepatocellular carcinoma and to take appropriate intervention measures in time is the key to improve survival rate of hepatocellular carcinoma patients.

References

[1]  Torre, L.A., Bray, F., Siegel, R.L., et al. (2015) Global Cancer Statistics, 2012. CA: A Cancer Journal for Clinicians, 65, 87-108.
https://doi.org/10.3322/caac.21262
[2]  Wang, W. and Wei, C. (2020) Advances in the Early Diagnosis of Hepatocellular Carcinoma. Genes & Diseases, 7, 308-319.
https://doi.org/10.1016/j.gendis.2020.01.014
[3]  Benson, A.B., D’Angelica, M.I., Abrams, T.A., et al. (2014) Hepatobiliary Cancers, Version 2.2014. Journal of the National Comprehensive Cancer Network, 12, 1152-1182.
https://doi.org/10.6004/jnccn.2014.0112
[4]  Heimbach, J.K., Kulik, L.M., Finn, R.S., et al. (2018) AASLD Guidelines for the Treatment of Hepatocellular Carcinoma. Hepatology, 67, 358-380.
https://doi.org/10.1002/hep.29086
[5]  吴孟超, 汤钊猷, 刘彤华, 等. 原发性肝癌规范化病理诊断指南(2015年版) [J]. 临床肝胆病杂志, 2015, 31(6): 833-839.
[6]  Wang, W., Guo, Y., Zhong, J., et al. (2021) The Clinical Significance of Microvascular Invasion in the Surgical Planning and Postoperative Sequential Treatment in Hepatocellular Carcinoma. Scientific Reports, 11, Article No. 2415.
https://doi.org/10.1038/s41598-021-82058-x
[7]  Bruix, J., Reig, M. and Sherman, M. (2016) Evidence-Based Diagnosis, Staging, and Treatment of Patients with Hepatocellular Carcinoma. Gastroenterology, 150, 835-853.
https://doi.org/10.1053/j.gastro.2015.12.041
[8]  Ishizawa, T., Hasegawa, K., Aoki, T., et al. (2008) Neither Multiple Tumors Nor Portal Hypertension Are Surgical Contraindications for Hepatocellular Carcinoma. Gastroenterology, 134, 1908-1916.
https://doi.org/10.1053/j.gastro.2008.02.091
[9]  Hou, Y.F., Wei, Y.G., Yang, J.Y., et al. (2016) Microvascular Invasion Patterns Affect Survival in Hepatocellular Carcinoma Patients after Second Hepatectomy. The Journal of Surgical Research, 200, 82-90.
https://doi.org/10.1016/j.jss.2015.06.069
[10]  Erstad, D.J. and Tanabe, K.K. (2019) Prognostic and Therapeutic Implications of Microvascular Invasion in Hepatocellular Carcinoma. Annals of Surgical Oncology, 26, 1474-1493.
https://doi.org/10.1245/s10434-019-07227-9
[11]  Imamura, H., Matsuyama, Y., Tanaka, E., et al. (2003) Risk Factors Contributing to Early and Late Phase Intrahepatic Recurrence of Hepatocellular Carcinoma after Hepatectomy. Journal of Hepatology, 38, 200-207.
https://doi.org/10.1016/S0168-8278(02)00360-4
[12]  Wang, M.D., Li, C., Liang, L., et al. (2020) Early and Late Recurrence of Hepatitis B Virus-Associated Hepatocellular Carcinoma. The Oncologist, 25, e1541-e1551.
https://doi.org/10.1634/theoncologist.2019-0944
[13]  Gouw, A.S.H., Balabaud, C., Kusano, H., et al. (2011) Markers for Microvascular Invasion in Hepatocellular Carcinoma: Where Do We Stand? Liver Transplantation, 17, S72-S80.
https://doi.org/10.1002/lt.22368
[14]  Zhang, X.P., Wang, K., Wei, X.B., et al. (2019) An Eastern Hepatobiliary Surgery Hospital Microvascular Invasion Scoring System in Predicting Prognosis of Patients with Hepatocellular Carcinoma and Microvascular Invasion after R0 Liver Resection: A Large-Scale, Multicenter Study. The Oncologist, 24, e1476-e1488.
https://doi.org/10.1634/theoncologist.2018-0868
[15]  Budhu, A., Forgues, M., Ye, Q.H., et al. (2006) Prediction of Venous Metastases, Recurrence, and Prognosis in Hepatocellular Carcinoma Based on a Unique Immune Response Signature of the Liver Microenvironment. Cancer Cell, 10, 99-111.
https://doi.org/10.1016/j.ccr.2006.06.016
[16]  Cong, W.M., Bu, H., Chen, J., et al. (2016) Practice Guidelines for the Pathological Diagnosis of Primary Liver Cancer: 2015 Update. World Journal of Gastroenterology, 22, 9279-9287.
https://doi.org/10.3748/wjg.v22.i42.9279
[17]  Yang, L., Gu, D., Wei, J., et al. (2019) A Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma. Liver Cancer, 8, 373-386.
https://doi.org/10.1159/000494099
[18]  Psaila, B. and Lyden, D. (2009) The Metastatic Niche: Adapting the Foreign Soil. Nature Reviews Cancer, 9, 285-293.
https://doi.org/10.1038/nrc2621
[19]  Pawlik, T.M., Delman, K.A., Vauthey, J.N., et al. (2005) Tumor Size Predicts Vascular Invasion and Histologic Grade: Implications for Selection of Surgical Treatment for Hepatocellular Carcinoma. Liver Transplantation, 11, 1086-1092.
https://doi.org/10.1002/lt.20472
[20]  周小泉, 赵凯亮, 王卫星. 肝细胞癌微血管侵犯术前预测因素及价值探讨[J]. 微循环学杂志, 2023, 33(2): 55-60.
[21]  Song, D.S. and Bae, S.H. (2012) Changes of Guidelines Diagnosing Hepatocellular Carcinoma during the Last Ten-Year Period. Clinical and Molecular Hepatology, 18, 258-267.
https://doi.org/10.3350/cmh.2012.18.3.258
[22]  Jiang, J.T., Wu, C.P., Xu, N.,et al. (2009) Clinical Evaluation of Serum α-Fetoprotein-IgM Immune Complexes on the Diagnosis of Primary Hepatocellular Carcinoma. Journal of Clinical Laboratory Analysis, 23, 213-218.
https://doi.org/10.1002/jcla.20321
[23]  Omata, M., Lesmana, L.A., Tateishi, R., et al. (2010) Asian Pacific Association for the Study of the Liver Consensus Recommendations on Hepatocellular Carcinoma. Hepatology International, 4, 439-474.
https://doi.org/10.1007/s12072-010-9165-7
[24]  Parikh, N.D., Mehta, A.S., Singal, A.G., et al. (2020) Biomarkers for the Early Detection of Hepatocellular Carcinoma. Cancer Epidemiology. Biomarkers & Prevention, 29, 2495-2503.
https://doi.org/10.1158/1055-9965.EPI-20-0005
[25]  Nanashima, A., Abo, T., Taura, N., et al. (2013) NX-PVKA Levels before and after Hepatectomy of Hepatocellular Carcinoma as Predictors of Patient Survival: A Preliminary Evaluation of an Improved Assay for PIVKA-II. Anticancer Research, 33, 2689-2697.
[26]  Liebman, H.A., Furie, B.C., Tong, M.J., et al. (1984) Des-Gamma-Carboxy (Abnormal) Prothrombin as a Serum Marker of Primary Hepatocellular Carcinoma. The New England Journal of Medicine, 310, 1427-1431.
https://doi.org/10.1056/NEJM198405313102204
[27]  Imamura, H., Matsuyama, Y., Miyagawa, Y., et al. (1999) Prognostic Significance of Anatomical Resection and Des-γ-Carboxy Prothrombin in Patients with Hepatocellular Carcinoma. The British Journal of Surgery, 86, 1032-1038.
https://doi.org/10.1046/j.1365-2168.1999.01185.x
[28]  Koike, Y., Shiratori, Y., Sato, S., et al. (2001) Des-Gamma-Carboxy Prothrombin as a Useful Predisposing Factor for the Development of Portal Venous Invasion in Patients with Hepatocellular Carcinoma: A Prospective Analysis of 227 Patients. Cancer, 91, 561-569.
https://doi.org/10.1002/1097-0142(20010201)91:3<561::AID-CNCR1035>3.0.CO;2-N
[29]  Poté, N., Cauchy, F., Albuquerque, M., et al. (2015) Performance of PIVKA-II for Early Hepatocellular Carcinoma Diagnosis and Prediction of Microvascular Invasion. Journal of Hepatology, 62, 848-854.
https://doi.org/10.1016/j.jhep.2014.11.005
[30]  Aoyagi, Y., Isemura, M., Suzuki, Y., et al. (1985) Fucosylated Alpha-Fetoprotein as Marker of Early Hepatocellular Carcinoma. Lancet, 2, 1353-1354.
https://doi.org/10.1016/S0140-6736(85)92643-1
[31]  Kumada, T., Nakano, S., Takeda, I., et al. (1999) Clinical Utility of Lens Culinaris Agglutinin-Reactive Alpha-Fetoprotein in Small Hepatocellular Carcinoma: Special Reference to Imaging Diagnosis. Journal of Hepatology, 30, 125-130.
https://doi.org/10.1016/S0168-8278(99)80016-6
[32]  Zhang, Z., Zhang, Y., Wang, Y., et al. (2016) Alpha-Fetoprotein-L3 and Golgi Protein 73 May Serve as Candidate Biomarkers for Diagnosing Alpha-Fetoprotein-Negative Hepatocellular Carcinoma. OncoTargets and Therapy, 9, 123-129.
https://doi.org/10.2147/OTT.S90732
[33]  Cho, E.S. AND Choi, J.Y. (2015) MRI Features of Hepatocellular Carcinoma Related to Biologic Behavior. Korean Journal of Radiology, 16, 449-464.
https://doi.org/10.3348/kjr.2015.16.3.449
[34]  Eguchi, S., Takatsuki, M., Hidaka, M., et al. (2010) Predictor for Histological Microvascular Invasion of Hepatocellular Carcinoma: A Lesson from 229 Consecutive Cases of Curative Liver Resection. World Journal of Surgery, 34, 1034-1038.
https://doi.org/10.1007/s00268-010-0424-5
[35]  胡伟, 马新, 袁亮. 肝细胞癌微血管侵犯与术后复发及预后的相关性[J]. 中国中西医结合外科杂志, 2017, 23(6): 587-590.
[36]  Liu, Y., Dai, Y., Zhang, X.X., et al. (2018) [Comparative Analysis of Anatomic and Non-Anatomic Hepatectomy for Single Small Hepatocellular Carcinoma with Microvascular Invasion]. Chinese Medical Journal, 98, 1937-1940.
[37]  Moris, D., Tsilimigras, D.I., Kostakis, I.D., et al. (2018) Anatomic Versus Non-Anatomic Resection for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis. European Journal of Surgical Oncology, 44, 927-938.
https://doi.org/10.1016/j.ejso.2018.04.018
[38]  Zhou, Y., Xu, D., Wu, L., et al. (2011) Meta-Analysis of Anatomic Resection versus Nonanatomic Resection for Hepatocellular Carcinoma. Langenbecks Archives of Surgery, 396, 1109-1117.
https://doi.org/10.1007/s00423-011-0784-9
[39]  Feng, L.H., Dong, H., Lau, W.Y., et al. (2017) Novel Microvascular Invasion-Based Prognostic Nomograms to Predict Survival Outcomes in Patients after R0 Resection for Hepatocellular Carcinoma. Journal of Cancer Research and Clinical Oncology, 143, 293-303.
https://doi.org/10.1007/s00432-016-2286-1
[40]  Liu, M., Wang, L., Zhu, H., et al. (2016) A Preoperative Measurement of Serum MicroRNA-125b May Predict the Presence of Microvascular Invasion in Hepatocellular Carcinomas Patients. Translational Oncology, 9, 167-172.
https://doi.org/10.1016/j.tranon.2016.03.002
[41]  聂彬, 赵铁军, 张胜龙. 肝细胞癌伴微血管侵犯不同切缘方案下根治术的预后分析[J]. 肝脏, 2023, 28(8): 921-923, 964.
[42]  Yoshida, Y., Kanematsu, T., Matsumata, T., et al. (1989) Surgical Margin and Recurrence after Resection of Hepatocellular Carcinoma in Patients with Cirrhosis. Further Evaluation of Limited Hepatic Resection. Annals of Surgery, 209, 297-301.
https://doi.org/10.1097/00000658-198903000-00008
[43]  Chen, M.S., Li, J.Q., Liang, H.H., et al. (2005) [Comparison of Effects of Percutaneous Radiofrequency Ablation and Surgical Resection on Small Hepatocellular Carcinoma]. Chinese Medical Journal, 85, 80-83.
[44]  Huang, J., Yan, L., Cheng, Z., et al. (2010) A Randomized Trial Comparing Radiofrequency Ablation and Surgical Resection for HCC Conforming to the Milan Criteria. Annals of Surgery, 252, 903-912.
https://doi.org/10.1097/SLA.0b013e3181efc656
[45]  Lü, M.D., Kuang, M., Liang, L.J., et al. (2006) [Surgical Resection versus Percutaneous Thermal Ablation for Early-Stage Hepatocellular Carcinoma: A Randomized Clinical Trial]. Chinese Medical Journal, 86, 801-805.
[46]  Minami, Y., Minami, T., Hagiwara, S., et al. (2018) Ultrasound-Ultrasound Image Overlay Fusion Improves Real-Time Control of Radiofrequency Ablation Margin in the Treatment of Hepatocellular Carcinoma. European Radiology, 28, 1986-1993.
https://doi.org/10.1007/s00330-017-5162-8
[47]  Llovet, J.M. and Bruix, J. (2003) Systematic Review of Randomized Trials for Unresectable Hepatocellular Carcinoma: Chemoembolization Improves Survival. Hepatology, 37, 429-442.
https://doi.org/10.1053/jhep.2003.50047
[48]  Chen, Z.H., Zhang, X.P., Zhou, T.F., et al. (2019) Adjuvant Transarterial Chemoembolization Improves Survival Outcomes in Hepatocellular Carcinoma with Microvascular Invasion: A Systematic Review and Meta-Analysis. European Journal of Surgical Oncology, 45, 2188-2196.
https://doi.org/10.1016/j.ejso.2019.06.031
[49]  Lau, W.Y., Lai, E.C.H., Leung, T.W.T., et al. (2008) Adjuvant Intra-Arterial Iodine-131-Labeled Lipiodol for Resectable Hepatocellular Carcinoma: A Prospective Randomized Trial-Update on 5-Year and 10-Year Survival. Annals of Surgery, 247, 43-48.
https://doi.org/10.1097/SLA.0b013e3181571047
[50]  Cheng, X., Sun, P., Hu, Q.G., et al. (2014) Transarterial (Chemo) Embolization for Curative Resection of Hepatocellular Carcinoma: A Systematic Review and Meta-Analyses. Journal of Cancer Research and Clinical Oncology, 140, 1159-1170.
https://doi.org/10.1007/s00432-014-1677-4
[51]  Wang, L., Ke, Q., Lin, N., et al. (2019) Does Postoperative Adjuvant Transarterial Chemoembolization Benefit for All Patients with Hepatocellular Carcinoma Combined with Microvascular Invasion: A Meta-Analysis. Scandinavian Journal of Gastroenterology, 54, 528-537.
https://doi.org/10.1080/00365521.2019.1610794
[52]  Agopian, V.G., Harlander-Locke, M., Zarrinpar, A., et al. (2015) A Novel Prognostic Nomogram Accurately Predicts Hepatocellular Carcinoma Recurrence after Liver Transplantation: Analysis of 865 Consecutive Liver Transplant Recipients. Journal of the American College of Surgeons, 220, 416-427.
https://doi.org/10.1016/j.jamcollsurg.2014.12.025
[53]  Liu, L., Cao, Y., Chen, C., et al. (2006) Sorafenib Blocks the RAF/MEK/ERK Pathway, Inhibits Tumor Angiogenesis, and Induces Tumor Cell Apoptosis in Hepatocellular Carcinoma Model PLC/PRF/5. Cancer Research, 66, 11851-11858.
https://doi.org/10.1158/0008-5472.CAN-06-1377
[54]  Kudo, M., Finn, R.S., Qin, S., et al. (2018) Lenvatinib Versus Sorafenib in First-Line Treatment of Patients with Unresectable Hepatocellular Carcinoma: A Randomised Phase 3 Non-Inferiority Trial. The Lancet, 391, 1163-1173.
https://doi.org/10.1016/S0140-6736(18)30207-1

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