Analysis Of Risk Factors For Progression To Primary Liver Cancer During Antiviral Therapy For Hepatitis B Cirrhosis

Objective: To investigate the risk factors of primary liver cancer in patients with hepatitis B cirrhosis after standardized antiviral therapy, and analyze the clinical characteristics of different types of traditional Chinese medicine.Methods: uses the method of retrospective study: collection of Hunan University of traditional Chinese medicine, the First Affiliated Hospital of liver disease / infectious diseases in 2010 January to January 2016 at admission, all 60 cases of new onset primary hepatocellular carcinoma cases(in hepatitis B cirrhosis cases the standard antiviral therapy based), as the case group(hepatocellular carcinoma(HCC) queue). At the same time hospitalized in the hospital in the same period the standard antiviral therapy of hepatitis B cirrhosis cases 60 cases as control group(cirrhosis queue). And to develop unified hepatitis B cirrhosis after antiviral therapy in primary liver cancer statistics, factors mainly include: gender, age, family history of liver cancer(first-degree relatives, secondary relatives), drinking history, smoking history, history of cirrhosis, anti viral treatment history, the titer of HBs Ag and HBe Ag, other disease history such as the history of diabetes, liver reserve function. The above liver cancer cohort of patients according to TCM syndrome points for liver stagnation and spleen deficiency syndrome, qi stagnation and blood stasis and damp heat poly toxic syndrome and liver kidney yin deficiency syndrome group, clinical differences were compared among the four groups, research content mainly liver function(alt, ALB, TBIL), AFP, clotting time(PT), child Pugh classification.Results: 1. by chi square test, there were significant differences in age and gender between the case group and the control group(P<0.05). 2. The single factor Logistic regression analysis showed that with the progression of hepatitis B cirrhosis during antiviral therapy for primary hepatocellular carcinoma associated with the following factors: gender, a family history of liver cancer and long-term heavy drinking history, HBs Ag titer(>6000 COI), HBe Ag positive, HBV-DNA positive, antiviral treatment process of withdrawal or reduction. Long term smoking history, diabetes history, liver reserve function and hepatitis B cirrhosis during the period of anti viral treatment, there was no significant correlation between the progression of primary liver cancer. 3. On the above statistical correlation factor and multi factor Logistic regression analysis, it is concluded that the following indicators and cirrhosis due to hepatitis B antiviral therapy during the progress of primary hepatocellular carcinoma(HCC) independently associated sex(OR=3.605, 95% CI 1.038-12.515) and level of family history of liver cancer(OR=7.548, 95% confidence interval(CI 1.214-47.353) long-term drinking history(OR=7.198, 95% CI 1.238-41.841) and HBe Ag positive(OR=7.450, 95% CI 1.800-30.829) and HBV-DNA positive(OR=14.577, 95% CI 3.907-54.389) stopped or reduced the dose(OR=12.612, 95% CI 1.573-117.172). 4. The study of primary liver cancer patients, spleen deficiency and dampness stagnancy syndrome in 23 cases(38.33%), qi stagnation and blood stasis syndrome in 17 cases(26.67), heat poly toxic syndrome in 19 cases(31.6%), yin deficiency of liver and kidney in 2 cases(3.33%). In the indexes of liver function in patients with primary liver cancer, ALT value order of spleen deficiency and dampness type > > fatigue type of qi stagnation and blood heat accumulation type virus, two two comparison between the groups, there were no significant differences(P>0.05); TBIL value from high to low order heat poly drug and blood type > Blood Stasis Type > spleen deficiency and dampness type, between the two two groups compared with other heat poly drug type between them had statistical significance(P<0.05), qi stagnation and blood stasis type and deficiency of the spleen wet storm type had no statistical significance between ALB(P>0.05); the value of the order of Qi stagnation and blood type. > > heat poly drug type of spleen deficiency and dampness type. Comparison of two two groups, there were no significant differences(P>0.05); the TCM syndrome type in patients with primary hepatocellular carcinoma PT value from high to low order heat poly drug type, blood stasis type, spleen deficiency and dampness type, were compared between the two two heat poly drug type and the other two Between them were statistically significant(P < 0.05), spleen deficiency and qi stagnation and blood stasis type wet trapped type has no statistical significance; liver function of child Pugh grade in primary patients with different TCM syndrome type in more obvious changes, from the syndrome of stagnation of liver qi and deficiency of the spleen and damp heat poly toxin type child- class a proportion of patients with decreased, and Child-C level the proportion of patients with increased, between each two car was statistically significant(P < 0.05); values of AFP in PLC patients with different TCM syndrome types from high to low heat poly toxin type > > due to stagnancy of Qi and blood stasis spleen wet storm, between each pairwise comparisons have statistical significance(P < 0.05).Conclusion:1. Hepatitis B antiviral therapy in patients with liver cirrhosis during progression to primary liver cancer risk factors for men, a family history of liver cancer and long-term heavy drinking history, HBe Ag, HBV-DNA and antiviral treatment process of withdrawal or reduction. 2.TBIL, Pt, AFP, child Pugh grade are different in various TCM syndrome types of HBV related hepatocellular carcinoma(HCC), heat poly toxic syndrome TBIL level is higher than that of liver stagnation and spleen deficiency syndrome of qi stagnation and blood stasis; heat poly toxic syndrome PT is higher than the level of liver stagnation and spleen deficiency syndrome of qi stagnation and blood stasis; poly(AFP level damp heat toxin syndrome > of qi stagnation and blood stasis type > liver stagnation and spleen deficiency syndrome; liver reserve function with the card type evolution and variation, liver stagnation and spleen deficiency syndrome of liver reserve function better, qi stagnation and blood stasis syndrome times, heat poly toxic syndrome is the worst.