| Objective:By collecting and organizing materials of 876 cases of patients who had been diagnosed with primary liver cancer for the first time, we analyzed the clinical features of these patients to deepen our understanding of PLC and to guide the diagnosis and treatment of PLC. Methods:We enrolled 876 cases of patients diagnosed with PLC for the first time, who had lived in The First Hospital of Jilin University during January 2013 to December 2015. We collected the patients’ data such as gender, age, family history, clinical symptoms, laboratory tests and imaging examination. And the statistics were analyzed by the SPSS 19.0 software.Results: 1. Of the 876 cases of patients firstly diagnosed with PLC, there were 688 males(78.5%) and 188 females(21.5%), and the male to female ratio was 3.65:1. And most of them were middle(656 cases, 74.9%) and old age patients(183 cases, 20.9%). The average age of the patients was(56.02±10.053)years. And the average age of men with PLC was significantly lower than women(t=-5.415,P=0.000). Of the 876 patients, there were 639 cases(72.9%) of HBV related primary liver cancer, 140 cases(16.0%) of HCV related primary liver cancer, 20 cases(2.3%) of HBV/HCV related primary liver cancer, 60 cases(6.8%) of alcohol related primary liver cancer, and 17 cases(1.9%) of other factors related primary liver cancer.2. Among the 876 patients, the common symptoms were abdominal pain or abdominal distension(551 cases, 62.9%), debilitation(116 cases, 13.2%), upper gastrointestinal bleeding(51 cases, 5.8%), jaundice(36 cases, 4.1%), fever(22 cases, 2.5%), edema(20 cases, 2.3%), and 48 cases’(5.5%) symptoms were not obvious.3. Analyzing the laboratory and imaging examination results:(1) the average level of CHE and PLT in the HBV/HCV related primary liver cancer group was lower than other groups(P≤0.05);(2) we found that the average level of PTA in the alcohol related primary liver cancer group was lower than other groups(P=0.007), and the average level of GGT in the alcohol related primary liver cancer group was higher than other groups(P=0.000). In the alcohol related primary liver cancer group, the longer the patients drink, the higher the level of GGT becomes(ρ=0.432,P=0.001);(3) the average level of ALT in the HCV related primary liver cancer group was higher than other groups(P=0.016);(4) the average level of AST and ALP in the HBV related primary liver cancer group were higher than other groups(both P<0.05).(5) the positive rate of AFP in the HBV related primary liver cancer group(85.0%) was higher than other groups(χ2=36.367,P=0.000), in the HCV related primary liver cancer group, in the HBV/HCV related primary cancer group, in the alcohol related primary liver cancer group and in the other factors related primary liver cancer group were 81.6%, 73.7%, 57.4% and 50.0% respectively;(7) the average diameter of the largest tumor and the incidence rate of portal vein tumor thrombus in the HBV related primary liver cancer group were greater and higher than other groups(both P<0.05).4. Child-Pugh grade and BCLC stage :(1) of the 876 patients who were diagnosed with PLC for the first time, 870 patients’ Child-Pugh grades were known, and the difference among the five groups(the HBV related primary liver cancer group, the HCV related primary liver cancer group, the HBV/HCV related primary liver cancer group, the alcohol related primary liver cancer group and other factors related primary liver cancer group) was not significant(χ2=6.017,P=0.645), with Child-Pugh A 376 cases(42.9%), Child-Pugh B 359 cases(41%), Child-Pugh C 135 cases(15.4%);(2) of the 876 patients who were diagnosed with PLC for the first time, 873 patients’ BCLC stages were known, and the difference among the five groups was not significant(χ2=25.844,P=0.056), with BCLC stage(0) 13 cases(1.5%), BCLC stage(A) 255 cases(29.1%), BCLC stage(B) 127 cases(14.5%), BCLC stage(C) 350 cases(40.0%), and BCLC stage(D) 128 cases(14.6%).5. There were 440 among the 606 patients with HBV related primary liver cancer who had not been under treatment against HBV. Among the 440 patients, the “HBs Ag(+), HBe Ab(+), HBc Ab(+)” group accounts for 52.7%(232 cases), the “HBs Ag(+), HBe Ag(+), HBc Ab(+)” group accounts for 29.5%(130 cases),the “HBs Ag(+), HBc Ab(+)” group accounts for 8.9%(39 cases),the “HBs Ag(+), HBe Ag(+), HBe Ab(+), HBc Ab(+)” group accounts for 3.9%(17 cases),the “HBe Ab(+), HBc Ab(+)” group accounts for 2.3%(10 cases),the “HBc Ab(+)” group accounts for 2.3%(10 cases)and the “HBs Ag(+), HBe Ab(+)” group accounts for 0.4%(2 cases)。And the HBV DNA load in the “HBs Ag(+), HBe Ag(+), HBc Ab(+)” group was higher than other groups(H=73.737,P=0.000). HBV DNA load was positively correlated with ascetic volume, ALT and AST level,Child-Pugh classification and BCLC stages(ρ=0.168,P=0.000;ρ=0.240,P=0.000;ρ=0.213,P=0.000; ρ=0.157,P=0.001; ρ=0.096,P=0.046), and was negatively correlated with ALB level(ρ=-0.165,P=0.001).6. Among the 140 patients with HCV related primary liver cancer, HCV RNA load was not correlated with ascetic volume, number of tumors, laboratory test results, Child-Pugh classification and BCLC stages(P>0.05).Conclusion:1. Among the 876 patients with PLC who were diagnosed for the first time, the number of the males was more than the females, and the male to female ratio was 3.65:1. Most of them were middle and old aged patients. The average age of these patient with PLC was(56.02±10.053)years. And the average age of the male patients was lower than the female patients.2. The common clinical symptoms of the patients who were diagnosed with PLC for the first time were abdominal pain or abdominal distension, debilitation, upper gastrointestinal bleeding, jaundice, fever and edema. And abdominal pain or abdominal distension was the most common symptoms.3.(1) The average level of CHE and PLT in the HBV/HCV related primary liver cancer group was lower than other groups.(2) The average level of PTA in the alcohol related primary liver cancer group was lower than other groups, and the average level of GGT was higher than other groups. In the alcohol related primary liver cancer group, the longer the patients drink, the higher the level of GGT becomes.(3) The average level of ALT in the HCV related primary liver cancer group was higher than other groups.(4) The average level of AST and ALP, the positive rate of AFP, the average diameter of the largest tumor and the incidence rate of portal vein tumor thrombus in the HBV related primary liver cancer group were higher than other groups.4. Patients with Child-Pugh A and B, and BCLC stage C accounts for a large part among the patients who were diagnosed with PLC for the first time.5. In the HBV related primary liver cancer group, the “HBs Ag(+), anti-HBe(+), anti-HBc(+)”group accounts for the largest. And HBV DNA load was positively correlated with ascetic volume, ALT and AST level,Child-Pugh classification and BCLC stages... |
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