Combined hematology, tumor morphology, and magnetic resonance imaging for predicting microvascular invasion in hepatocellular carcinoma: a clinical study

Background: Microvascular invasion (MVI) is an independent risk factor for postoperative recurrence in hepatocellular carcinoma (HCC), making preoperative prediction clinically critical. This study aimed to identify factors associated with MVI and develop a clinically applicable predictive model using patient-derived variables, including serological markers, tumor morphology, and magnetic resonance imaging (MRI) features. Methods: A retrospective analysis was conducted on 236 patients with HCC who underwent surgical resection between January 1, 2019, and December 31, 2022, at the Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Guangdong Medical University. Patients were randomly assigned to training and validation cohorts at a 1:1 ratio. Significant factors identified through univariate analysis with P values adjusted via the Benjamini-Hochberg method (adjusted P800 ng/mL (OR =3.407, P=0.035), and intratumoral vascular enhancement (OR =6.300, P=0.022). In the training cohort, the area under the curve (AUC), sensitivity, specificity and Youden index (YI) of the nomogram were 0.871 (P