| Objective:(1)To explore the influencing factors of postoperative curative effect in patients with active hepatocellular carcinoma of hepatitis B.(2)To explore the expression of IL-6 in cancer tissues of patients with active and inactive hepatocellular carcinoma,and to clarify the effect of IL-6 expression on the prognosis of patients with active hepatocellular carcinoma of hepatitis B.Methods:(1)Clinical study: retrospective analysis of the medical records of patients who underwent radical hepatectomy in the Department of Hepatobiliary surgery of the affiliated Hospital of Youjiang Medical University for nationalities from January 2016 to June2019.The postoperative pathology was confirmed as hepatocellular carcinoma(HCC)and the active stage of hepatitis B.By consulting the literature,we collected the factors that may affect the postoperative factors of hepatocellular carcinoma in active stage of hepatitis B,such as body mass index(Body mass index,BMI),Child-phgh grade of liver function on admission,sex,Alpha-fetoprotein,AFP level on admission,age,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(tota lbilirubinon admission,TBIL)level,tumor size,tumor number,operation method,intraoperative bleeding,operation time,hepatic portal occlusion,integrity of tumor capsule,portal vein tumor thrombus,microvascular invasion,satellite nodule,distant metastasis,tumor differentiation,tumor stage,complicated with liver cirrhosis and so on.SPSS25.0 software was used for statistical analysis.Kaplan-Meier method was used to compare the difference of postoperative 1-and 3-year survival rate between active hepatocellular carcinoma group and inactive hepatocellular carcinoma group,and the risk factors affecting the survival time of patients with active hepatocellular carcinoma were analyzed.The risk factors affecting prognosis were obtained by Log rank test,and the significant factors in univariate analysis were included in the multivariate Cox proportional hazard regression model to obtain the independent risk factors affecting prognosis.(2)Immunohistochemistry: the liver cancer tissue samples of 20 patients with active hepatocellular carcinoma and 15 patients with inactive hepatocellular carcinoma were collected from the Department of Hepatobiliary surgery of the affiliated Hospital of Youjiang Medical University for nationalities from January 2018 to June 2019.The expression of IL-6 in patients with active and inactive hepatocellular carcinoma was detected by immunohistochemical method,and the effect of IL-6 expression on the prognosis of patients with active hepatocellular carcinoma was analyzed.SPSS25.0 software was used for statistical analysis,the measurement data were expressed by(x ±s),and the differences between groups were compared by two independent samples t-test.Results:(1)The 1-year and 3-year survival rates of patients with active hepatocellular carcinoma of hepatitis B were lower than those of patients with inactive hepatocellular carcinoma,which were 83.1% vs 88.1% and 52.8% vs 71.1%,respectively,and the difference was statistically significant(all P < 0.05).(2)Univariate analysis showed that portal vein tumor thrombus,intact capsule,satellite nodules,microvascular invasion,tumor number,tumor stage and distant metastasis were correlated with the prognosis of postoperative patients with active hepatocellular carcinoma of hepatitis B(all P < 0.05).Multivariate analysis showed that portal vein tumor thrombus,satellite nodules and microvascular invasion were independent risk factors for postoperative prognosis of patients with active hepatocellular carcinoma of hepatitis B(all P<0.05).(3)The expression of IL-6 in patients with active hepatitis B hepatocellular carcinoma was higher than that in patients with inactive hepatitis B hepatocellular carcinoma(P<0.05).(4)The expression of IL-6 in cancer tissue did not affect the 1-year and 3-year survival rate of patients with active hepatocellular carcinoma of hepatitis B(all P > 0.05).Conclusion:(1)The independent risk factors affecting the postoperative prognosis of patients with active hepatocellular carcinoma of hepatitis B are portal vein tumor thrombus,satellite nodules and microvascular invasion.(2)The expression level of IL-6 in HCC patients with active hepatitis B was stronger than that in patients with inactive hepatocellular carcinoma.(3)The expression level of IL-6 in cancer tissue may not be a factor affecting the prognosis of patients with active hepatocellular carcinoma of hepatitis B,which needs to be demonstrated by accumulating more samples. |
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