| Background Primary liver cancer(PLC,hereinafter referred to as liver cancer)can be divided into three types according to the pathological characteristics: hepatocellular carcinoma(HCC),intrahepatic cholangiocarcinoma(ICC),mixed liver cancer(HCC-ICC),among which HCC is the most common,accounting for more than 90%.There are many risk factors for HCC.In China,most of the occurrence of HCC is related to hepatitis B virus(HBV)infection.At present,there are a few studies on the relationship between HBV DNA loading and clinicopathological characteristics of HCC.Some studies have explored the molecular mechanism of HBV-induced HCC,suggesting that HBV infection has a certain correlation with the occurrence,treatment and prognosis of HCC,but the conclusion is unclear.Objective Retrospectively analyze the relationship between HBV DNA load and clinicopathological characteristics and prognosis of HCC and provide clues and guidance for the prognosis of HCC.Methods Among the 440 HCC patients admitted to Zhongda hospital from January 1,2016 to March 31,2019,251 patients were selected through strict inclusion and exclusion criteria,and analyze the relationship between HBV DNA and the clinical pathological characteristics of HCC.The collected data are processed and analyzed with SPSS.22.Counting data such as age and other normally distributed continuous variable data are analyzed by t test,categorical data such as gender are analyzed by chi-square test,and non-normally distributed data are analyzed by rank sum test.The Kaplan-Meier method is used for survival analysis,and the log-rank test is used for comparison.The survival curve considered P< 0.05 as considered statistically significant.Results 1.53.9% male HBV DNA load is higher than normal,although greater than the female ratio of 42.0%,this difference is not statistically significant(χ~2 = 2.301,P = 0.129).2.The average age of the low HBV DNA load group was 62.22 ± 11.629 years old,the average age of the high HBV DNA load group was 58.68 ± 11.705 years old,the difference was 3.538(95% confidence interval 0.635-6.440),t = 2.401,P = 0.017,indicating that there is a statistical difference between the two groups.3.In patients with normal AFP,30.3% of patients had HBV DNA load higher than normal;in patients with abnormal AFP,56.0% of patients had HBV DNA load higher than normal,the difference between the two groups was statistically significant(χ~2 = 13.836,P < 0.001).4.In patients with normal CEA,48.7% of patients had HBV DNA load higher than normal;in patients with abnormal CEA,50.0% had HBV DNA load higher than normal.There is no statistically significant difference between the two groups(χ~2 = 0.019,P = 0.889).5.In patients with normal CA 19-9,44.3% of patients had higher HBV DNA load;in patients with abnormal CA 19-9,62.1% had higher HBV DNA load,the difference between the two groups was statistically significant(χ~2 = 5.433,P = 0.020).6.In patients with low-differentiation tumor tissues,54.5% had HBV DNA load higher than normal;In patients with moderate-differentiation,45.3% had HBV DNA load higher than normal;In patients with high-differentiation,38.1% had HBV DNA load.The amount was higher than the normal level,but the difference between the three groups is not statistically significant(P = 0.661).7.In patients with tumor diameter <5 cm,47.8% of patients had HBV DNA load higher than normal;In patients with tumor diameter ≥ 5 cm,48.0% had HBV DNA load higher than normal,but the difference between the two groups is not statistically significant(χ~2 < 0.001,P = 0.990).8.In patients without tumor thrombus infiltration,53.3% had HBV DNA load higher than normal;In patients with cancer thrombus infiltration,41.7% had HBV DNA load higher than normal,but the difference between the two groups is not statistically significant(χ~2 = 0.506,P = 0.477).9.In massive hepatocellular carcinoma,33.3% of patients had higher HBV DNA load than normal;in nodular liver cancer patients,50.0% had higher HBV DNA load than normal;in small liver cancer patients,46.2% had HBV DNA The load was higher than normal,but this difference is not statistically significant(χ~2 = 0.963,P = 0.618).10.69 patients were treated with antiviral therapy and antitumor therapy,whose 3-and 5-year survival rate are 37.68% and 26.09%,respectively;114 patients did not receive antiviral therapy but treated with antitumor therapy,whose 3-year and 5-year survival rates were 31.58% and 9.65%,respectively.There is no significant difference in survival rates between the two groups(P = 0.718).11.In the HBV DNA low-load group,37 patients were treated with antiviral therapy and antitumor therapy,whose 3-and 5-year survival rate are 51.35% and 32.43%,respectively;61 patients who did not receive antiviral therapy but treated with antitumor therapy,whose 3-and 5-year survival rate are 42.62% and 11.48%,respectively.There is no significant difference in survival rates between the two groups(P = 0.754).12.In the HBV DNA high-load group,32 patients were treated with antiviral therapy and antitumor therapy,whose 3-and 5-year survival rate 21.88% and 18.75%,respectively;53 patients did not receive antiviral therapy but treated with antitumor therapy,whose 3-and 5-year survival rate are 18.87% and 7.55%,respectively.There is no significant difference in survival rates between the two groups(P = 0.249).13.The 3-and 5-year survival rates of the HBV DNA low-load group are 42.34% and 18.02%,respectively;the 3-and 5-year survival rates of the HBV DNA high-load group were 17.82% and 9.90%,respectively.The difference between the two groups is statistically significant(P < 0.001).Conclusion 1.Younger HCC patients are more likely to have high levels of HBV DNA load;HCC patients with high levels of HBV DNA load are prone to have high serum AFP or CA 19-9 levels;HBV DNA load level in HCC patients has no correlation with tumor tissue differentiation,tumor size,tumor thrombus infiltration,and tumor morphology.2.No matter in low-load or high-load HBV DNA group,antiviral therapy cannot provide survival benefits for HCC patients;The survival time of patients with lower load is longer,the survival time of patients with higher load is shorter. |
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