Objective:The current study aims to establish a risk model for microvascular invasion(MVI)in patients with hepatocellular carcinoma(HCC),which is based on radiological characteristics and clinical laboratory data,and to explore the clinical application of preoperative alpha -fetoprotein(AFP)and gamma -glutamyl transferase(GGT)in HCC patients. Methods:Clinical data from 479 HCC patients with surgically resection at the First Affiliated Hospital of Nanjing Medical University were retrospectively collected to investigate the effects of potentially relevant factors on MVI,and to assess the benefits of serum AFP and GGT on improving model predictive performance. Univariate and multivariate logistic regression analyses were used to select variables for the final prediction model,and the predictive performance of the model was assessed by area under the receiver operating characteristic curve(AUC),calibration curve,and decision curve analysis(DCA). Predictive performance was compared by sensitivity,specificity and accuracy analyses. Kaplan - Meier curves were applied to assess the probability of patient survival. Results:In a multifactorial analysis,tumor size,borders of the tumor,exophytic growth,AFP and GGT were independent predictors for the development of MVI in HCC patients. Two models were constructed with or without AFP and GGT,respectively. In both cohorts,model A with AFP and GGT showed better predictive performance than model B without AFP and GGT,with AUCs of 0.902(0.872-0.932)and 0.876(0.842-0.909), respectively. The two models showed good discrimination,and the predicted probabilities were in good agreement with the observed probabilities. Analysis of the DCA,which assesses the net clinical benefit of the models,showed that model A was slightly better than model B,both with good clinical application. In the subgroup analysis,AFP and GGT could well predict the prognosis of HCC patients. Conclusion:A predictive model for the development of MVI in patients with HCC was developed,and the study confirmed the clinical predictive value of serum AFP and GGT.