| Objective:Analysis of clinical features of hepatocellular carcinoma(HCC)in patients with HBV-DNA clearance after HBV infection,and further analysis of its survival time after diagnosis of hepatocellular carcinoma.Methods:Patients who developed into HCC after infecting HBV in our department were admitted to,the information collection time from June 2014 to June 2017,according to the level of serum HBV-DNA in patients with HCC diagnosis,they were divided into HBVDNA positive group and HBV-DNA negative group.The clinical general data of patients,laboratory inde-xes,the usage of antivirals and survival time after diagnosis of HCC were collected.The data were processed by SPSS19.0 software,and the continuous variables of the two groups were compared by Mann-whitney U test,the categorical variable of the two groups were compared by chisquare test,the survival time of the two groups ware analyzed by Kaplan-Meier method and Log-rank test,with significant difference P<0.05.Results:1.A total of 104 patients were included in this research,mainly male patients,with61 patients in the HBV-DNA negative group,and 43 patients in the HBV-DNA positive group.2.During diagnosis of HCC,compared with the HBV-DNA positive group,patients in the HBV-DNA negative group had older ages during the diagnosis of HCC(median age 56 vs 52,P=0.046),lower proportion of liver cirrhosis(77% vs 93%,P=0.030),higher proportion of antiviral therapy acceptance(70.5% vs 25.6%,P<0.001).3.During diagnosis of HCC,there was a significant difference in the proportion of HBe Ag/ HBe Ab between the two groups(P < 0.05).HBV-DNA negative patients showed lower proportion of HBe Ag(+)/HBe Ab(-)and higher proportion of HBe Ag(-)/HBe Ab(-),but in the HBV-DNA positive group,the result was the opposite.4.There was a significant difference between the two groups in the level of ALT and PLT in the diagnosis of HCC(P < 0.05),with lower ALT and PLT levels in the HBV-DNA negative group.5.At the end of the follow-up,there were 34 patients who died from HCC,2 patients survived more than 5 years,the median survival time was 42 months,and the 1 years,3years and 5 years survival rates were 76.5%,58.1%,27.1%.6.In the HBV-DNA negative group,the 1 year,3 year,and 5 year survival rates were84.8%,68.7%,and 38.2%.In the HBV-DNA positive group,the 1 year,3 year,and 5 year survival rates were 64.8%,43.3%,0%,the survival rates of HBV-DNA negative group was higher than that of HBV-DNA positive group,the difference was significant(?2 = 7.712,P= 0.005).7.For patients treated with antiviral therapy before diagnosied of HCC,the 1 year,3year and 5 year survival rates of HBV-DNA negative group and HBV-DNA positive group were 83.9%,67.6%,54.1% and 74.1%,47.0%,0%,respectively.There was a significant difference in survival rate(? 2 = 4.527,P < 0.033).8.For patients untreated with antiviral therapy before diagnosied of HCC,the 1 year,3 year and 5 year survival rates of HBV-DNA negative group and HBV-DNA positive group were 85.7%,71.4%,0% and 53.0%,39.8%,0%,respectively.There was no significant difference in survival rate(? 2 =3.304 P 0.069).9.For patients treated with antiviral therapy more than 2 year before diagnosied of HCC,the 3 year,5 year survival rate was significantly higher than that in the patients treated with less than 2 years(67.4%,40.4%VS 44.4%,0%).Conclusion:1.The HBV infection patients with HBV-DNA negative were older in diagnosis of HCC,most of them receive long-term effective antiviral therapy,the degree of cirrhosis improves or reverses and even e-antigen disappearance,indicating the necessity of continuous monitoring in the course of the disease.And early diagnosis and treatment of HCC should be carried out.2.During diagnosis of HCC,the survival rate of HBV-DNA negative patients was higher than that of HBV negative patients,and long term antiviral therapy before HCC can prolo-ng the further survival rate of patients,which suggested that early and effective antiviral therapy is the key to delay the progression of patients with HBV infection. |
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