Abstract: Objective To explore the risk factors of microvascular invasion (MVI) after radical hepatectomy for hepatitis B virus (HBV)-related hepatocellular carcinoma. Methods One hundred and twenty patients with hepatitis B-related liver cancer in General Hospital of Eastern Theater Command from January 2020 to June 2024 were retrospectively selected. All patients underwent operation of radical hepatectomy. According to the postoperative pathological results, they were divided into a MVI group (n=30) and a non-MVI group (n=90). The general data of both groups of patients were compared and the levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), carbohydrate antigen 19-9 (CA19-9), alpha fetoprotein (AFP), neutrophil to lymphocyte ratio (NLR), and carcinoembryonic antigen 19-9 (CA19-9)/gamma glutamyl transpeptidase (GGT) ratio of all patients were measured; The risk factors of MVI after radical hepatectomy for hepatitis B-related liver cancer were identified through multiple factors and unconditional logistic stepwise regression analysis. Results The proportion of pathological low differentiation (66.67%), tumor maximum diameter>5 cm (73.33%), capsule enhancement (70.00%), AFP>400 μg/L (60.00%), NLR level (3.21 ± 1.02), CA19-9/GGT level (3.03 ± 0.56) in the MVI group were higher than those of the proportion of pathological low differentiation (33.33%), tumor maximum diameter>5 cm (47.78%), capsule enhancement (48.89%), NLR level (1.75 ± 0.56), CA19-9/GGT level (2.41 ± 0.47), AFP>400 μg/L (40.00%)} in the non-MVI group (P<0.05); Pathological poor differentiation (OR=2.685, 95%CI:1.124～6.414), maximum tumor diameter>5 cm (OR= 2.756, 95% CI:1.231～6.170), capsule enhancement (OR=2.674, 95% CI:1.198～5.969), NLR (OR=2.168, 95%CI:1.321～3.558), CA19-9/GGT (OR: 1.639, 95% CI: 1.210～2.220), AFP>400 μg/L (OR: 2.895,95% CI: 1.358～6.172) are the risk factors of patients with MVI after radical hepatectomy for hepatitis B-related liver cancer (all P<0.05). Conclusion The occurrence of MVI in patients with hepatitis B-related liver cancer after radical hepatectomy is closely related to poor pathological differentiation, tumor maximum diameter>5 cm, capsule enhancement, NLR, CA19-9/GGT ratio, AFP>400 μg/L, and thus these should be closely monitored in clinical practice.

Key words: Hepatitis B virus, Hepatocellular carcinoma, Radical liver resection, Microvascular invasion, Risk factors