| Objective:The clinical data of primary liver cancer of Zhuang nationality in western Guangxi were retrospectively analyzed and compared with those of non-Zhuang nationality,and the clinical characteristics and prognostic factors of primary liver cancer of Zhuang nationality in western Guangxi were discussed in order to provide reference for clinical diagnosis and treatment of primary liver cancer.Methods:A retrospective analysis was conducted on 376 cases of primary liver cancer of Zhuang nationality and 142 cases of non-Zhuang primary liver cancer hospitalized in our hospital from January 1,2016 to September 20,2018.The clinical data that may affect the patients with primary liver cancer of Zhuang nationality in western Guangxi were collected and recorded,and the survival time of the patients was recorded by telephone follow-up.SPSS 22.0 statistical software was used to analyze the data,and P<0.05 was regarded as statistically significant.Results:1 Epidemiological data of patients.1.1 Age,sex.A total of 518 patients with primary liver cancer were included,including 376 cases of primary liver cancer of Zhuang nationality,331 male patients(88.0%)and 45 female patients(12.0%).There were 142 cases of primary liver cancer in non-Zhuang nationality,including114 males and 28 females.1.2 personal history,past history,family history.There were 376 cases of liver cancer in Zhuang nationality,including 173 cases of smoking(46.0%),203 cases of drinking(54.0%),293 cases of previous HBV infection(77.9%),HCV infection,14 cases of diabetes(3.7%),of which 160 cases(42.6%)had a history of liver cirrhosis and 14 cases(3.7%)had family history.Among the 142 cases of non-Zhuang primary liver cancer,60(42.3%)had a history of smoking and 63(44.4%)had a history of drinking.There were 106 cases of previous HBV infection(74.6%),HCV infection3 cases(2.1%),12 cases had a history of diabetes(8.5%),70 cases(49.3%)had a history of liver cirrhosis,and 2 cases had a family history(1.4%).There was no significant difference in smoking,drinking history,HBV infection history,HCV infection history,liver cirrhosis history and family history between Zhuang and non-Zhuang liver cancer patients in western Guangxi(P>0.05).However,non-Zhuang patients with liver cancer were more common with diabetes,and the difference was statistically significant(P<0.05).2 clinical symptoms.When the patient was admitted to the hospital,the doctor recorded the current medical history for the first time as the first symptom of the patient.In patients with primary liver cancer of Zhuang nationality,there were 274 cases(72.9%)of primary liver pain,and 134cases(35.6%)had portal vein tumor thrombus at the time of treatment.Among the non-Zhuang patients with primary liver cancer,105 cases(73.9%)had initial liver pain,and48 cases(33.8%)had portal vein tumor thrombus at the time of treatment.There was no statistical difference in the first clinical symptoms between Zhuang and non-Zhuang patients with primary liver cancer(P>0.05).3 laboratory index.3.1Alpha-fetoprotein(AFP).The serum values of AFP in patients with primary liver cancer of Zhuang nationa lity were AFP<400ug/L in 200 cases(53.2%),400?AFP<800ug/L in 21 cases(5.6%),800?AFP<1200ug/L in 12 cases(3.2%),AFP?1200ug/L in 143(38.0%).AFP serumvalue of non-Zhuang primary liver cancer patients AFP<400ug/L 72 cases(50.7%),400?AFP<800ug/L8 cases(5.6%),800?AFP<1200ug/L in 1 case(0.7%),AFP?1200ug/L in 61 cases(43.0%).There was no significant difference in AFP between Zhuang natio nality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).3.2 Total bilirubin(TBIL).TBIL levels of patients with primary liver cancer of Zhuang nationality were TBI L<34umol/L in 286 cases(76.1%),34?TBIL<51umol/L in 24 cases(6.4%),TBIL?51um ol/L in 66 cases(17.6%).Patients with primary liver cancer of non-Zhuang nationality had TBIL<34umol/L in 108 cases(76.1%),34?TBIL<51umol/L in 13 cases(9.2%);TBIL?51umol/L in 21 cases(14.8%).There was no significant difference in TBIL be tween Zhuang nationality and non-Zhuang nationality in patients with primary liver ca ncer(P>0.05).3.3 Cerealthirdtransaminase(ALT).There were 172 patients with ALT<40U/L(45.7%),ALT?40U/L in 204 cases(54.3%)of Zhuang nationality with primary liver cancer.There were 62 non-Zhuang patients with primary liver cancer whose ALT<40U/L(43.7%),ALT?40U/L in 80 cases(56.3%).There was no significant difference in ALT between Zhuang nationality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).3.4 Aspartate transaminase(AST).There were 93 patients with AST<40U/L(24.7%),AST?40U/L in 283 cases(75.3%)in Zhuang nationality patients with primary liver cancer.There were 31 patients w ith AST<40U/L(21.8%),AST?40U/L in 111 cases(78.2%)in non-Zhuang nationality patients with primary liver cancer.There was no significant difference in AST between Zhuang nationality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).3.5 Glutamyl transpeptidase(?-GT).Patients with primary liver cancer of Zhuang nationality had ?-GT?55U/L in 72cases(19.1%)and ?-GT>55U/L in 304 cases(80.9%).Patients with primary liver canc er of non-Zhuang nationality had ?-GT?55U/L in 21 cases(14.8%)and ?-GT>55U/L in 121 cases(85.2%).There was no significant difference in ?-GT between Zhuang n ationality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).3.6 Serum albumin(ALB).Patients with primary liver cancer of Zhuang nationality had serum ALB?35g/L in 167cases(44.4%),28?ALB<35g/L in 144 cases(38.3%),and ALB<28g/L in 65 cases(17.3%).Non-Zhuang patients with primary liver cancer had serum ALB?35g/L in 77 cases(54.2%),28?ALB<35g/L in 48 cases(33.8%),and ALB<28g/L in 17 cases(12.0%).There was no significant difference in ALB between Zhuang nationality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).4 Child-Pugh grading.In patients with primary liver cancer of Zhuang nationality,there were 197 cases of Child-Pugh grade A(52.4%),B grade 134 cases(35.6%),C grade 45 cases);non-Zhuang nationality primary liver cancer patients Child-Pugh grade A 82 cases(57.7%),B grade 45cases)(31.7%),C grade 15 cases(10.6%).There was no significant difference in Child-Pugh classification between Zhuang nationality and non-Zhuang nationality in patients with primary liver cancer(P>0.05).5 treatment regimen.The treatment options of patients with primary liver cancer of Zhuang nationality and non-Zhuang nationality were mainly supported therapy in 225 cases(59.8%)and 87 cases(61.3%).There was no significant statistical difference in the choice of treatment between Zhuang and non-Zhuang people(P>0.05).6 overall survival analysis of primary liver cancer in Zhuang nationality.In this study,the follow-up time of 376 patients with primary liver cancer of Zhuang nationality in western Guangxi was December 31,2019,280 died and 96 survived.The average survival time was 17.79 months,and the median survival time was 5.56 months.Univariate analysis of COX model showed that AFP,AST,?-GT,TBIL,ALB,Child-Pugh grade,portal vein tumor thrombus and treatment had significant influence on the survival time of Zhuang patients with liver cancer.By introducing the above 8 univariate indexes which were significantly related to prognosis into COX model,multivariate regression analysis showed that(forward LR),AFP,Child-Pugh grade,portal vein tumor thrombus and treatment were independent factors affecting the prognosis of primary liver cancer in Zhuang nationality.ALT,AST,GGT,ALB,portal vein tumor thrombus and treatment methods of non-Zhuang nationality patients with liver cancer have significant influence on the survival time of non-Zhuang nationality patients with liver cancer,while ?-GT,portal vein tumor thrombus and treatment methods are independent factors affecting the prognosis of non-Zhuang nationality patients with primary liver cancer.Conclusion:1.Among the patients with primary liver cancer of Zhuang nationality,middle-aged and elderly men are more common,and hepatitis B virus infection is the main cause.2.There were differences in independent factors affecting the prognosis of primary liver cancer between Zhuang nationality and non-Zhuang nationality: AFP,Child-Pugh grade,portal vein tumor thrombus and the mode of treatment were the independent factors affecting the prognosis of primary liver cancer in Zhuang nationality.?-GT,portal vein tumor thrombus and the method of treatment were independent factors affecting the prognosis of non-Zhuang nationality patients with primary liver cancer.3.In the early follow-up monitoring of patients with primary liver cancer of the Zhuang nationality,most of the patients were AFP-negative(53.2%),and a single AFP was easy to be missed as a follow-up test,but the higher the AFP value,the shorter the survival time and theworse the prognosis.4.The percentage of non-Zhuang nationality patients with primary liver cancer complicated with diabetes is much higher than that of Zhuang nationality,but due to the small sample size of this study,it is impossible to judge whether diabetes is an influencing factor of liver cancer. |
PDF Full Text Request