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A standardized pathological proposal for evaluating microvascular invasion of hepatocellular carcinoma: a multicenter study by LCPGC

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机构： [1]Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Rd, Shanghai 200438, China [2]Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China [3]Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China [4]Department of Pathology, West China Hospital of Sichuan University, Chengdu, China [5]Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, China [6]Department of Pathology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China [7]Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China [8]Department of Pathology, The 900Th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China [9]Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Chongqing, China [10]Department of Pathology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China [11]Department of Pathology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China [12]Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China [13]Department of Pathology, Guangzhou First People’s Hospital, Guangzhou, China [14]Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China [15]Department of Pathology, The General Hospital of the People’s Liberation Army, Beijing, China [16]Department of Pathology, Xiangya Hospital, Central South University, Changsha, China [17]Department of Pathology, Peking University Cancer Hospital and Institute, Beijing, China [18]Department of Pathology, The First Hospital of China Medical University, Shenyang, China [19]Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dong An Rd, Shanghai 200032, China [20]Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xian, China [21]Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China [22]Department of Pathology, Changzheng Hospital, Shanghai, China [23]Department of Pathology, Affiliated Cancer Hospital of Nantong University, Nantong, China [24]Department of Pathology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China [25]Department of Pathology, Shanxi Cancer Hospital, Taiyuan, China [26]Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, China [27]Department of Pathology, Zhongshan Hospital, Xiamen University, Xiamen, China [28]Institute of Pathology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China [29]Department of Pathology, The Second Hospital of Anhui Medical University, Hefei, China [30]Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, China [31]Department of Pathology, Xuzhou Cancer Hospital, Xuzhou, China [32]Genome Wisdom Institute, 67 North Fourth Ring West Rd, Beijing 100800, China

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关键词： Grading Hepatocellular carcinoma Microvascular invasion Prognosis Recurrence Sampling

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Background and aims: Microvascular invasion (MVI) is a key pathological factor that severely affects the postoperative prognosis of patients with hepatocellular carcinoma (HCC). However, no MVI classification schemes based on standardized gross sampling protocols of HCC are available at present. Methods: 119 HCC specimens were sampled at multiple sites (3-, 7-, and 13 points) for the optimum MVI detection rate. 16,144 resected HCCs were graded as M0, M1 or M2 by adopting three-tiered MVI grading (MVI-TTG) scheme based on the seven-point sampling protocol (SPSP). Survival analyses were performed on 2573 patients to explore the advantages of MVI-TTG. Results: The MVI detection rate determined by SPSP was significantly higher than that determined by the 3-point sampling method (34.5% vs. 47.1%, p = 0.048), but was similar to that determined by the 13-point sampling method (47.1% vs. 51.3%, p = 0.517). Among 16,144 resected HCCs, the proportions of M0, M1 and M2 specimens according to SPSP were 53.4%, 26.2% and 20.4%, respectively. Postoperative survival analysis in 2573 HCC patients showed that the 3-year recurrence rates in M0, M1 and M2 MVI groups were 62.5%, 71.6% and 86.1%, respectively (p < 0.001), and the corresponding 3-year overall survival (OS) rates were 94.1%, 87.5% and 67.0%, respectively (p < 0.001). M1 grade was associated with early recurrence, while M2 grade was associated with both early and late recurrence. MVI-TTG had a larger area under the curve and net benefit rate than the two-tiered MVI grading scheme for predicting time to recurrence and OS. Conclusions: SPSP is a practical method to balance the efficacy of sampling numbers and MVI detection rates. MVI-TTG based on SPSP is a better prognostic predictor than the two-tiered MVI scheme. The combined use of SPSP and MVI-TTG is recommended for the routine pathological diagnosis of HCC. © 2020, Asian Pacific Association for the Study of the Liver.

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出版当年[2020]版：

大类 | 3 区医学

小类 | 4 区胃肠肝病学

最新[2023]版：

大类 | 2 区医学

小类 | 3 区胃肠肝病学

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出版当年[2020]版：

Q2 GASTROENTEROLOGY & HEPATOLOGY

最新[2023]版：

Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子： 5.9 最新[2023版] 6.6 最新五年平均 6.047 出版当年[2020版] 5.975 出版当年五年平均 5.102 出版前一年[2019版] 9.046 出版后一年[2021版]

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第一作者机构： [1]Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Rd, Shanghai 200438, China

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A standardized pathological proposal for evaluating microvascular invasion of hepatocellular carcinoma: a multicenter study by LCPGC

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