中国实用外科杂志2025，Vol.45Issue(4)：450-456,7.DOI:10.19538/j.cjps.issn1005-2208.2025.04.12
肿瘤出芽对微血管侵犯阴性肝细胞癌病人预后预测价值及术后辅助治疗效果评价
Prognostic value of tumor budding in hepatocellular carcinoma patients with negative microvascular invasion and evaluation of postoperative adjuvant therapy efficacy
摘要
Abstract
Objective To evaluate the prognostic value of tumor budding(TB)in patients with microvascular invasion(MVI)negative hepatocellular carcinoma(HCC)and to explore the impact of postoperative adjuvant therapy with tyrosine kinase inhibitors(TKI)and prophylactic transarterial chemoembolization(TACE)on the prognosis of TB-positive patients.Methods A retrospective analysis was conducted on the clinical data of 186 MVI-negative HCC patients who underwent curative surgery at the First Affiliated Hospital of Xi'an Jiaotong University,the Second Affiliated Hospital of Xi'an Jiaotong University,and Shaanxi Provincial People's Hospital between 2016 and 2020.TB was assessed through pathological and immunohistochemical examinations.The Cox proportional hazards model was used to analyze prognostic factors,and Kaplan-Meier survival curves were employed to compare the survival benefits of postoperative adjuvant therapies in the TB-positive subgroup.Follow-up was conducted until June 1,2022.Results Among the patients,85(45.6％)were TB-positive.Multivariate Cox regression analysis revealed that tumor T stage(HR=1.617,95％CI 1.157-2.260,P=0.005),preoperative AFP levels＞400 μg/L(HR=2.255,95％CI 1.294-3.928,P=0.004),and tumor diameter＞5 cm(HR=3.529,95％CI 1.311-9.411,P=0.011)were independent risk factors for overall survival(OS).TB positivity(HR=2.763,95％CI 1.687-4.526,P＜0.001),tumor multiplicity(HR=7.031,95％CI 1.751-28.229,P=0.006),and tumor diameter＞5 cm(HR=2.748,95％CI 1.343-5.623,P=0.06)were independent risk factors for recurrence-free survival(RFS).The subgroup analysis of TB-positive patients indicated that postoperative treatment with TKI and prophylactic TACE did not improve RFS or OS.Conclusion TB serves as an independent prognostic indicator for assessing recurrence risk in MVI-negative hepatocellular carcinoma patients and an important supplement to MVI.For TB-positive patients,the current postoperative adjuvant treatment strategies(TKI/TACE)did not demonstrate a significant improvement in prognosis,highlighting the need for exploring treatment strategies with better target abilities.关键词
肝细胞癌/肿瘤出芽/微血管侵犯/酪氨酸激酶抑制剂/动脉化疗栓塞术Key words
hepatocellular carcinoma/tumor budding/microvascular invasion/tyrosine kinase inhibitors/transarterial chemoembolization分类
医药卫生引用本文复制引用
杨凯博,贾非,杨泽荣,唐卓人,吴坤瑾,万永,常虎林,曲凯..肿瘤出芽对微血管侵犯阴性肝细胞癌病人预后预测价值及术后辅助治疗效果评价[J].中国实用外科杂志,2025,45(4):450-456,7.基金项目
陕西省重点研发计划-重点产业链项目(No.2024SF-ZDCYL-02-14) Key Research and Development Program of Shanxi(No.2024SF-ZDCYL-02-14) （No.2024SF-ZDCYL-02-14）
