| ObjectiveTo explore the related factors for primary hepatic carcinoma(PHC)with chronic hepatitis B(CHB)and hepatitis C(CHC).To reduce the development of PHC with chronic hepatitis,prolong the life of patients with chronic hepatitis and improve survival and quality of life.Using the information management system to analyze the proportion and possible trend of PHC with HBV and PHC with HCV.MethodsCross-sectional studyThis study selected CHB and CHC as participants who coincidence inclusion criterias.Information such as demographics,lifestyles,diagnosis and treatment of hepatitis and PHC,and other diseases were collected by questionnaires.According to the clinical diagnosis the patients were divided into a chronic hepatitis group and a PHC group.Unconditional logistic regression was performed to explore the related factors for PHC with CHB and PHC with CHC.Historical medical records analysisThis study selected PHC as participants from selected hospitals from 2010 to 2015.To analyze the proportion of PHC with HBV,PHC with HCV according to the year of admission date.ResultsCross-sectional study:A total of 609 chronic hepatitis patients were recruited from selected hospitals.According to the clinical diagnosis the CHB patients(n=480)were divided into a chronic hepatitis group(n=275)and a PHC group(n=205),and the CHC patients(n=129)were divided into a chronic hepatitis group(n=102)and a PHC group(n=27).1.Comparison of age and sex in CHB(n=480)and CHC(n=129):Age of CHC was older than that of CHB(t=5.27,P<0.001).The proportion of male in CHB was higher than that in CHC(χ2=19.66,P<0.001).2.Related factors for PHC with CHB:Univariate regression analysis indicated that development of PHC with CHB was significantly associated with age,sex,household register,occupational physical activity,alcohol consumption,smoking,green tea consumption,coffee consumption,antiviral treatment,diabetes mellitus,family history of PHC(P<0.05),and was not significantly associated with education,fish consumption,fatty liver,hyperlipidemia(P>0.05).The year of antiviral treatment was a dose-response relationship,the values of OR of antiviral treatment<10 years and≥10 years were 0.22(0.15～0.33)and 0.14(0.03～0.65),χ2 trend had statistical significance(χ2=58.02,P<0.001).Multivariate regression analysis indicated that green tea consumption(OR=0.39,95%CI:0.20～0.77),antiviral treatment(OR=0.18,95%CI:0.11～0,31)were negatively correlated with development of PHC with CHB.Male(OR=3.55,95%CI:1.73～7.25),alcohol consumption(OR=2.00,95%CI:1.04～3.85),household register in countryside(OR=2.38,95%CI:1.25～4.55),family history of PHC(OR=4.08,95%CI:2.18～7.65)were positively correlated with development of PHC with CHB.3.Related factors for PHC with CHC:Univariate regression analysis indicated that development of PHC with CHC was significantly associated with age,sex,alcohol consumption,antiviral treatment(P<0.05),and was not significantly associated with household register,occupational physical activity,smoking,green tea consumption,coffee consumption,fish consumption,fatty liver,hyperlipidemia,diabetes mellitus,family history of PHC(P>0.05).The antiviral treatment(OR=0.20,95%CI:0.06～0.66)was negatively correlated with development of PHC with CHC.Age of 55 years or more(OR=5.23,95%CI:1.72～15.92),alcohol consumption(OR=3.34,95%CI:1.04～10.74)were positively correlated with development of PHC with CHC.Historical medical records analysis:Retrieved 4569 cases of PHC,and average age was 55.4 years.Male PHC were 3694 cases(80.8%).1.The distribution of age and gender:Age of female PHC was older than that of male PHC(F=78.31,P<0.001).Age of PHC with HCV was older than that of PHC with HBV(F=269.42,P<0.001).The proportion of male in PHC with HBV was higher than that in PHC with HCV(χ2=65,18,P<0.001).2.The proportion of HBV and HCV in PHC:Proportion of hepatitis b in PHC was 71.6%between 2011 and 2015,proportion of hepatitis c in PHC was 5.2%.Proportion of hepatitis b in male PHC(75.0%)was higeher than that in female PHC(57.5%)(χ2=106.63,P<0.001).Proportion of hepatitis c in male PHC(4.2%)was lower than that in female PHC(9.7%)(χ2=43.88,P<0.001).There were no obvious changes.ConclusionCross-sectional indicated that antiviral treatment may prevent the occurrence of PHC.Alcohol consumption increased the risk of CHB.For CHB and CHC patients should stop alcohol consumption and receive antiviral treatment under the guidance of doctors.For CHB patients with family history of PHC and the aged CHC patients should be alert to the risk of PHC,should be monitored and follow-up closely.Historical medical records analysis indicated that the main PHC was HBV infection,the proportion of hepatitis b and hepatitis c in PHC were no obvious trend.The average age of male patients with PHC was less than that of female,which may be related to the lifestyle habits(such as alcohol)and the hormone.The proportion of male in PHC with HBV was higher than that in PHC with HCV,the average of PHC with HCVwas older than that in PHC with HBV,which may be related to the age of infection of HBV and HCV. |
