关键词: 肝细胞肝癌, 微血管侵犯（MVI）, 新辅助治疗, 多因素分析

Abstract: Objective To investigate the influencing factors of postoperative microvascular invasion （MVI） in hepatocellular carcinoma （HCC） patients and provide a theoretical basis for neoadjuvant therapy. Methods Clinical data of 995 HCC patients who underwent surgery at Sun Yat-sen Memorial Hospital between January 2020 and December 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MVI positivity. Results A total of 995 patients were included, with an MVI positivity rate of 38.4% （382/995）. Univariate analysis revealed significant differences between MVI-positive and MVI-negative groups in tumor stage （P<0.001）, differentiation grade （P<0.001）, and proportion of preoperative adjuvant therapy （P=0.044）. Multivariate analysis demonstrated that advanced tumor stage （OR=3.171） and absence of preoperative adjuvant therapy （OR=3.312） were independent risk factors for MVI positivity, while well-differentiated tumors served as a protective factor （OR=0.275） （all P<0.05 ）. Conclusion Higher tumor stage, poorer differentiation, and absence of preoperative adjuvant therapy significantly increase the risk of postoperative MVI in HCC patients. Individualized preoperative adjuvant therapy based on tumor stage and differentiation grade may reduce MVI risk.

Key words: hepatocellular carcinoma, microvascular invasion, neoadjuvant therapy, multivariate analysis