title: Development and validation of a novel predictive scoring model for microvascular invasion in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) cannot be accurately predicted preoperatively. This study aimed to establish a predictive scoring model of MVI in solitary HCC patients without macroscopic vascular invasion.
  
  
  METHODS
  A total of 309 consecutive HCC patients who underwent curative hepatectomy were divided into the derivation (n=206) and validation cohort (n=103). A predictive scoring model of MVI was established according to the valuable predictors in the derivation cohort based on multivariate logistic regression analysis. The performance of the predictive model was evaluated in the derivation and validation cohorts.
  
  
  RESULTS
  Preoperative imaging features on CECT, such as intratumoral arteries, non-nodular type of HCC and absence of radiological tumor capsule were independent predictors for MVI. The predictive scoring model was established according to the β coefficients of the 3 predictors. Area under receiver operating characteristic (AUROC) of the predictive scoring model was 0.872 (95% CI, 0.817-0.928) and 0.856 (95% CI, 0.771-0.940) in the derivation and validation cohorts. The positive and negative predictive values were 76.5% and 88.0% in the derivation cohort and 74.4% and 88.3% in the validation cohort. The performance of the model was similar between the patients with tumor size ≤5cm and >5cm in AUROC (P=0.910).
  
  
  CONCLUSIONS
  The predictive scoring model based on intratumoral arteries, non-nodular type of HCC, and absence of the radiological tumor capsule on preoperative CECT is of great value in the prediction of MVI regardless of tumor size.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Nanjing Medical University Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Hua
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu, China.
authors.forename: Tu
authors.initials: T
authors.lastname: Dai
authors.affiliation: Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Min
authors.initials: M
authors.lastname: Tang
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Fu
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Mao
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu, China. Electronic address: 45687061@qq.com.
authors.forename: Huihan
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address: yudongqiu510@163.com.
authors.forename: Yudong
authors.initials: Y
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media
keywords: Ct; Hepatocellular carcinoma; Microvascular invasion; Predictive scoring model