The Clinical Characteristics Of 731 Patients With Hepatitis B-related Primary Liver Cancer

ObjectiveThis study analyzed the clinical records of patients with hepatitis B who have been diagnosed with primary liver cancer for the first time in the past five years in the First Hospital of Lanzhou University,focusing on the impact of antiviral therapy on hepatitis B-related primary liver cancer,and the clinical features and risk factors of tumor vascular invasion,so as to provide clinical evidence for the diagnosis and treatment of hepatitis B-related primary liver cancer.MethodsA retrospective analysis of 731 patients with hepatitis B who was diagnosed with primary liver cancer for the first time at the First Hospital of Lanzhou University from December 2014 to July 2019 was divided into antiviral treatment group and non--antiviral treatment group based on the history of antiviral treatment,To study the differences between the two groups in general information,laboratory examinations,tumor imaging features,liver function grading,and tumor staging;The tumor was divided into vascular invasion group and non-vascular invasion group according to the presence or absence of vascular invasion,Through comparative analysis of clinical data to explore independent risk factors for tumor vascular invasion.Results1.This research concludes 731 patients with hepatitis B-related primary liver cancer,594 were male(81.3%)and 137 were female(18.7%).The ratio of male to female was 5.3:1,and tthe peak age of onset was 50-59 years.The test results of hepatitis B system showed that the positive rate of HBsAg was 94.8%;the positive rate of HBeAg was 40.1%.220 patients(30.1%)had previous antiviral treatment.Imaging examination data showed that 368 cases(50.3%)of single nodular tumors,363 cases(49.7%)of multi-nodular tumors,264 cases(36.1%)with tumors accounting for liver volume >50%,and 290 cases of vascular invasion(39.6%),125 cases(17.1%)had extrahepatic metastasis.Child-Pugh score grade A,grade B,grade C was 444 cases,237 cases,50 cases,respectively,accounting for 60.7%,32.4%,6.8% of the total number of cases;ECOG PS score grade 0,grade 1,grade 2,grades 3,grades 4 was 232 cases,409 cases,78 cases,10 cases,and 2 cases respectively,accounting for 31.7%,56.0%,10.7%,1.4%,and 0.3% of the total number;BCLC staging of early,very early,intermediate,advanced and terminal stages were 27 cases,80 cases,46 cases,518 cases and 60 cases,respectively,accounting for 3.7%,10.9%,6.3%,70.9%,8.2% of the total number.2.The results of the comparative analysis of the antiviral treatment group and the non-antiviral treatment group showed that the antiviral treatment group had mild systemic inflammatory response,better liver function,lower tumor markers and HBVDNA levels,the tumor was mainly single,and the tumor diameter was Smaller,The proportion of liver invasion area >50%,the portal vein invasion and extrahepatic metastasis was less,and the BCLC stage was earlier.3.A univariate analysis of vascular invasion of hepatitis B-related primary liver cancer tumors found that compared with the non-vascular invasion group,the proportion of antiviral treatment in the vascular invasion group was smaller,the inflammatory response was more serious,the liver function damage was more obvious,tumor markers and HBV-DNA levels was higher.The tumors are mainly multiple,with a larger diameter,a wide area of liver invasion,a stronger tumor aggressiveness,more prone to extrahepatic metastasis,and a higher liver function grade and ECOG PS grade.4.Binary Logistic regression analysis of hepatitis B-related primary liver cancer tumor vascular invasion showed that the larger BMI and the higher the PTA were the protective factors for the hepatitis B-related primary liver cancer vascular invasion,while the higher GGT,LDL-C,FIB values,the larger tumor diameter,the wider liver invasion area,and the extrahepatic metastasis were its independent risk factors.Conclusion1.Hepatitis B-related primary liver cancer is more common in men,and the age of onset is mainly middle-aged and elderly.The disease usually occult onset,Most of the patients have merged with tumor vascular invasion or extrahepatic metastasis at the initial diagnosis.The tumor staging is dominated by the progression stage,and the prognosis is poor.2.Antiviral therapy can inhibit viral replication,reduce systemic inflammation in patients with hepatitis B-related primary liver cancer,improve liver function,reduce portal vein invasion,extrahepatic metastasis,reduce tumor stage,and delay disease progression.3.The Larger BMI and the higher PTA are the protective factors for vascular invasion of hepatitis B-related primary liver cancer,while the higher GGT,LDL-C and FIB values,the larger tumor diameter,the wider area of liver invasion,and the combined extrahepatic metastasis are its independent risk factors.4.In clinical practice,early screening of hepatitis B and hepatitis B-related liver cancer high-risk groups should be strengthened,and early antiviral treatment should be used to delay disease progression,reduce vascular invasion and extrahepatic metastasis,and improve prognosis.