| Objective: The aim of this article is to explore the related factors of HBV related hepatocellular carcinoma(HCC), such as gender, age, drinking history,family history, infection way, the degree of lesion, HBV DNA and AFP.According to the study, we could observe the occurence of primary liver cancer in patients with those risk factors early. It’s meaningful for the early diagnosis and treatment of primary liver cancer.Methods: In this study, we selected 242 cases of HBV related HCC from the people’s hospital of Langfang city and the central hospital of China national petroleum corporation,and 169 cases of chronic hepatitis B as control from January 2005 to December 2014. The risk factors below were enregistered: general conditions, such as name, gender, age, vocation, marital status, native place and place of residence; medical history, such as the course of disease, drinking history(the time and the quantity, alcohol consumption(g)=drink(ml) *alcohol concentration*0.8), family history, the kind of antiviral drugs, the efficacy of antiviral treatments, the course of treatment, the way of infection(vertical transmission, paternal-infant transmission,injection or blood transfusion), clinical types of HCC; and auxiliary examination, such as serological markers for HBV, HBV DNA, routine blood test(RBC, WBC, PLT, Hb), biochemical tests(ALT, AST, GGT, TBIL, ALB),AFP, radiologic criteria and the histopathological diagnosis.The related factors above were analyzed by Logistic regression analysis.Statistical analysis were performed using the SPSS 17.0,P<0.05 was considered to be statistically significant.Results:1 General conditions1.1 AgeIn the cancer group and control group, the age of morbidity were 57(25,83) vs 49(27, 82) respectively(P<0.001). The majority in HBV related primary liver cancer group was 50-59.1.2 GenderThe ratio of male/female was 5.37:1 in the cancer group, and 2.77:1 in control(P=0.005).1.3 VocationThe distribution of vocation between the two group considered to be no statistical significance(P=0.453).1.4 AreaThe distribution of the place of residence between two groups was considered to be no statistical significance(P=0.053). But there was higher incidence in Guangyang, Anci and Yongqing in the cancer group.1.5 Family historyThere were no statistical significance of the family history of cirrhosis and hepatitis B between two groups, however, the family history of liver cancer was higher than control(P=0.021).1.6 Drinking historyAmong the investigated cases of two groups, there were 75 and 26 cases accompanied with a history of abusing alcohol(P<0.001).2 Related factors of HBV infection2.1 The way of infectionThe way of vertical transmission is higer in the cancer group, compared to control(P=0.003).2.2 HBV DNAThere were no statistical significance of the distribution of HBV DNA levels between two groups(P=0.177).2.3 Hbe AgThere were 204 cases in cancer group(84.30%),while 124 cases in control(63.27%), which differed significantly in statistical analysis(P<0.001).2.4 AFPIn cancer group, the levels of AFP: <20ng/ml(26,10.74%),20-200ng/ml(27,11.16%),200-400ng/ml(24,9.92%),>400ng/ml(165,68.18%),while the levels of AFP were all less than 200ng/ml in control.2.5 Course of diseaseThere were 195 cases of cirrhosis in cancer group and 68 cases in control,which differed significantly in statistical analysis(P<0.001).2.6 Antiviral treatmentThe effective cases of antiviral treatment were 30 in cancer group and164 in control.3 Logistic Regression Analysis of the risk factors of HBV related primary cancerThe univariate logistic analysis pointed out that the risk factors of HBV related HCC were: older than 50, male, vertical transmission, family history of liver cancer, cirrhosis, HBe Ag(-), heavy drinking, ineffective antiviral treatment or never. The multivariate analysis showed that the risk factors including older than 50, male, vertical transmission, family history of HCC,cirrhosis.Conclusions:1 The analysis of HBV related HCC in Langfang region from 2005 to2014: The higher incidence occurred in those which were older than 50, male,vertical transmission, family history of HCC and accompanied with cirrhosis.However,HBe Ag negative, heavy drinking and ineffective or never received antiviral treatment may also be risk factors in HBV related primary liver cancer.2 This study suggested that the patients with those risk factors above should monitor the levels of AFP, ultrasonography, CT or MRI of liver regularly. |
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