To construct a preoperative predictive model of primary hepatocellular carcinoma (HCC) microvascular invasion (MVI) and to verify its accuracy.

The clinicopathological data of 160 HCC patients underwent hepatectomy from January 2017 to June 2019 were analyzed retrospectively to observe the MVI status of the patients. SPSS20.0 software was used to process and to analyze the data. Count data were examined by using χ² test; measurement data were examined by using independent t test; Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors affecting MVI, and to construct a preoperative predictive model of primary hepatocellular carcinoma MVI. To evaluate the predictive ability of the model and verify the predictive model with the postoperative pathological diagnosis results as the gold standard.

Among 160 patients, 86 had MVI and 74 had no MVI. Logistic multivariate regression analysis of statistically significant clinical pathology data from single factor analysis showed that tumor diameter, peritumoral hypoechoic halo, alpha-fetoprotein (AFP) level, platelet-to-lymphocyte ratio (PLR) level, and circulating tumor DNA (ctDNA) concentration were independent risk factors for primary hepatocellular carcinoma MVI. According to the logistic regression analysis of the regression coefficients of each variable to construct a prediction model, by drawing the ROC curve, the AUC value was calculated to be 0.914 (95% CI 0.820-0.962). When the optimal cut-off value is 0.069, it has predictive value for primary hepatocellular carcinoma MVI. The sensitivity is 86.5%, the specificity is 87.9%, and the Youden index is 0.74. Using the postoperative pathological diagnosis as the gold standard to verify the prediction model, the sensitivity was 88.4% and the specificity was 93.2%. There was no statistical difference in sensitivity and specificity between them (P>0.05).

The establishment of a prediction model based on Logistic multi-factor regression analysis has a high sensitivity and specificity, and has a high predictive value for patients with primary hepatocellular carcinoma microvascular invasion, It could provide reference for the preoperative treatment plan and surgical planning of hepatocellular carcinoma patients.