The influencing factors for tumor thrombus in patients with hepatocellular carcinoma

Area of Science:

• Oncology
• Hepatology
• Surgical Pathology

Background:

• Microvascular invasion (MVI) is a critical indicator of early metastasis and poor prognosis in liver cancer.
• Accurate prediction of tumor thrombus formation is essential for improving patient survival rates.
• Hepatocellular carcinoma (HCC) risk factors for tumor thrombus require further investigation.

Purpose of the Study:

• To identify independent predictors of tumor thrombus grades in patients diagnosed with HCC.
• To assess the association between clinical, pathological, and imaging features and tumor thrombus formation.
• To evaluate the diagnostic efficacy of combining key predictors for tumor thrombus grading.

Main Methods:

• Retrospective analysis of 231 HCC patients from August 2011 to December 2022.
• Classification into MVI-negative, MVI-positive, and portal vein tumor thrombus (PVTT) groups.
• Univariate and multiple logistic regression analyses to identify risk factors; ROC curve analysis for cutoff values.

Main Results:

• Univariate analysis showed significant differences in tumor diameter, AFP, Ki-67, gender, tumor quantity, arteriovenous fistula, peritumoral enhancement, and satellite nodules.
• Ki-67 expression level, tumor diameter, and peritumoral enhancement were identified as independent risk factors for tumor thrombus grades.
• The combination of tumor diameter (cutoff 4.1 cm) and Ki-67 (cutoff 17.5%) achieved an AUC of 0.805 for predicting tumor thrombus.

Conclusions:

• Tumor diameter, Ki-67 expression, and peritumoral enhancement serve as independent predictors for tumor thrombus in HCC.
• Combining tumor diameter and Ki-67 expression enhances the diagnostic accuracy for tumor thrombus grading.
• These findings aid in predicting prognosis and guiding treatment strategies for HCC patients.