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Microvascular invasion (MVI) diagnosis relies on postoperative pathological examinations, underscoring the urgent need for a novel diagnostic method. C-Reactive Protein (CRP), has shown significant relevance to hepatocellular carcinoma (HCC) prognosis. This study aims to explore the relationship between preoperative serum CRP levels and microvascular invasion in hepatocellular carcinoma and develop a nomogram model for predicting MVI. Patients were categorized into MVI-positive and MVI-negative groups for analysis. Serum CRP levels were compared between the two groups. And then use LASSO regression to screen variables and build a nomogram. CRP levels showed significant differences between the MVI-positive and MVI-negative groups. Multivariable logistic regression analysis identified CRP (OR = 4.85, P < 0.001), lnAFP (OR = 3.11, P < 0.001), WBC count (OR = 2.73, P = 0.003), and tumor diameter (OR = 2.38, P = 0.01) as independent predictors of MVI. A nomogram based on these variables showed good predictive performance in both the training and validation cohorts with dual validation. The clinical prediction nomogram model, which includes serum CRP levels, WBC count, tumor diameter, and serum AFP levels, showed good performance in predicting MVI in both the training and validation cohorts. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the clinicopathological and ultrasonography characteristics of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and its correlation with microvascular invasion (MVI), as well as the predictive value of contrast-enhanced ultrasound (CEUS) imaging. Methods: A retrospective analysis was conducted on 57 patients diagnosed with cHCC-CCA between November 2017 and May 2023 at Guizhou Provincial People's Hospital. Among them, 27 patients were MVI-positive and 30 patients were MVI-negative, all of whom underwent preoperative CEUS within 2 weeks. Clinical data, ultrasonographic findings, and CEUS features were compared between the two groups to analyze the influencing factors and predictive value of MVI in cHCC-CCA patients. Results: Compared to the MVI-negative group, the MVI-positive group showed a higher proportion of tumors with a maximum diameter greater than 5 cm, elevated alpha-fetoprotein (AFP) levels, low echo halo around the tumor, non-smooth tumor contour, peripheral irregular rim-like enhancement and early washout (≤60s) with nodular patterns on CEUS (P<0.05). Multivariate logistic regression analysis revealed that low echo halo, peripheral irregular rim-like enhancement, and early washout were independent risk factors for MVI in cHCC-CCA patients. The receiver operating characteristic (ROC) curve analysis demonstrated an area under the curve (AUC) of 0.8056 for these factors. Conclusions: Ultrasonographic and CEUS features have a certain correlation with MVI in cHCC-CCA patients. Low echo halo, peripheral irregular rim-like enhancement, and early washout are independent risk factors for MVI in patients with cHCC-CCA. These features have a predictive value in determining the presence of MVI in patients with cHCC-CCA. [ABSTRACT FROM AUTHOR]

To develop and validate a cross-modality tensor fusion (CMTF) model using multi-modality MRI radiomics features and clinical radiological characteristics for the prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). This study included 174 HCC patients (47 MVI-positive and 127 MVI-negative) confirmed by postoperative pathology. The synthetic minority over-sampling technique was used to augment MVI-positive samples. The amplified dataset of 254 samples (127 MVI-positive and 127 MVI-negative) was randomly divided into training and test cohorts in a 7:3 ratio. Radiomics features were respectively extracted from arterial phase, delayed phase, diffusion-weighted imaging, and fat-suppressed T2-weighted imaging. The least absolute shrinkage and selection operator was used for feature selection. Univariate and multivariate logistic regression analyses were employed to identify clinical and radiological independent predictors. The selected multi-modality MRI radiomics features, clinical and radiological characteristics were used to construct the CMTF model, single modality (SM) model, early fusion (EF) model. The CMTF model demonstrated superior performance in predicting MVI compared to the SM and EF models. When integrating four MRI modalities, the CMTF model achieved a high area under the curve (AUC) with 95 % confidence interval (95 % CI) of 0.894 (0.820–0.968). Additionally, incorporating clinical and radiological characteristics further enhanced the predictive performance of CMTF model, the AUC (95 % CI) value increased to 0.945 (0.892–0.998). The CMTF model showed promising performance in preoperative MVI prediction, providing a more effective non-invasive detection tool for HCC patients. [ABSTRACT FROM AUTHOR]

The research aimed to create and verify a nomogram model that can predict the likelihood of cholangiocarcinoma with microvascular invasion (MVI). The clinical data of 476 patients with surgically confirmed cholangiocarcinoma were collected retrospectively. This included 240 cases of intrahepatic cholangiocarcinoma (iCCA), 85 cases of perihilar cholangiocarcinoma (pCCA), and 151 cases of extrahepatic cholangiocarcinoma (eCCA). Using this data, we conducted forward multivariate regression analysis to identify the factors that influence the risk of preoperative MVI in patients with cholangiocarcinoma. And using these variables, we developed three nomogram models. The variables in the model for predicting MVI of iCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.831 and 0.781, respectively. The variables in the model for predicting MVI of pCCA were lymph node metastasis, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.791 and 0.747. And the variables in eCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.834 and 0.830. we have developed and validated a preoperative nomogram model for predicting MVI in patients with iCCA, pCCA, and eCCA. • There are variations in symptoms across various types of cholangiocarcinoma. • Precisely identifying microvascular invasion before treatment is crucial. • We make predictions about microvascular invasion by the nomogram models. • Microvascular invasion has significant implications for the treatment plan. [ABSTRACT FROM AUTHOR]

To investigate the impact of surgical resection margin and hepatic resection type on prognosis and compare their prognostic significance on patients with hepatocellular carcinoma (HCC) with or without microvascular invasion (MVI) who underwent laparoscopic liver resection (LLR). A retrospective analysis was conducted on 320 patients with HCC who underwent LLR. According to the grading of MVI, patients were classified as M0, M1 and M2. Patients were divided into the anatomical resection (AR) and nonanatomical resection (NAR) groups according to the hepatic resection type. Survival and Cox regression analyses were performed to explore the effects of AR and NAR, wide and narrow resection margin on overall survival (OS) and time to recurrence (TTR). In the whole cohort, narrow resection margin was an independent risk factor for OS and TTR, whereas NAR was not. Subgroup analysis showed that narrow resection margin and NAR were both independent risk factors for OS and TTR in HCC patients with MVI. The 5-year OS and TTR rates of the two groups (NAR-wide resection margin and AR-narrow resection margin) with M1 were 85.3 % versus 62 % and 34.4 % versus 60.2 %. Similarly, the 5-year OS and TTR rates of the two groups (NAR-wide resection margin and AR-narrow resection margin) with M2 were 80.2 % versus 47.9 % and 30.8 % versus 64.8 %. Anatomical hepatectomy and wide resection margin were independent protective factors for HCC patients with MVI receiving LLR. Nonetheless, wide resection margin had a greater impact on prognosis than anatomical hepatectomy. [ABSTRACT FROM AUTHOR]