Nucleos(t)ide Analogues Improved Survival Of CHB-related HCC Patients And IL-34 With CHB Related Liver Disease

Aims:The aim of the current study was to explore if there is reverse correlation between NAs and severity of HCC,including differentiation and progression in CHB patients.To investigate the relationship between IL-34,MCSF and the hepatitis B viral related liver disease,including chronic hepatitis B,hepatitis B related cirrhosis and hepatitis B related Hepatocellular carcinoma.Methods:1.Screening single-center retrospective study of CHB-related HCC diagnosed and treated at Shanghai Ruijin Hospital from January 2008 to November 2015.The baseline characteristics of the patients were recorded and the NAs treatment,BCLC scores,liver function of patients with CHB-related HCC was recorded.The patients were divided into NAs treatment group and NAs na?ve group.Follow-up of patients with advanced prognosis and treatment of CHB-related HCC patients.The patients with CHB-related HCC were divided into three groups:sustained NAs,NAs post-HCC and NAs na?ve.The prognosis of the three groups was analyzed and compared.The factors influencing the prognosis of patients with CHB-related HCC were analyzed by univariate analysis and multivariate analysis.2.The levels of IL-34 and MCSF in serum were measured by sera from patients with CHB,cirrhosis and CHB-related HCC in the Department of Infectious Diseases in ruijin hospital.The expression of IL-34,MCSF and CD68 in liver tissue was analyzed by immunohistochemical.Results:1.Among 532 original identified patients between 2008 and 2015,there were 118 or 414CHB-related HCC with or without NAs therapy.BCLC scores,serum level of ALT/AST and HBV DNA were compared.In the follow-up period,the survival period of CHB-related HCC patients with sustained NAs is significantly longer than that with NAs post-HCC and NAs na?ve(p<0.05).Factors significantly associated with the poor overall survival of CHB-related HCC,as determined by Cox stepwise selection regression model,include BCLC scores(hazard ratio,1.84[95%confidence interval,1.57-2.15],p<0.001),NAs post-HCC or NAs na?ve(1.33[1.07-1.65],P<0.01),serum AST?40 IU/L(1.48[1.03-2.12],P<0.05)and HBV DNA?10~4 copies/ml(1.36[1.01-1.83],P<0.001).2.The serum IL-34 and MCSF levels in patients with CHB related hepatocellular carcinoma was significantly higher than that of the other three groups(CHB,CHB related cirrhosis,CHB related HCC and health people).CHB-related HCC in patients with liver immunohistochemical detection of IL-34,MCSF higher than the other three groups.Conclusions:1.NAs reduced severity of CHB-related HCC patients.Sustained NAs is an important factor associated with the extended survival of CHB-related HCC patients.2.IL-34 and MCSF have a certain correlation with CHB related liver diseases.IL-34may be a predictor of CHB-related HCC.