Analysis Of Clinical Characteristics And Risk Factors Of Patients With Hepatitis B Virus Associated Primary Liver Cancer

ObjectiveThis study conducted a retrospective analysis of clinical records of patients diagnosed with hepatitis B-related primary liver cancer at the First Hospital of Lanzhou University over the past seven years.The study focuses on exploring the clinical characteristics of these patients in different serological statuses,aiming to provide new perspectives and ideas for research on the seroconversion of HBe Ag/HBs Ag and the mechanism of hepatitis B-related primary liver cancer.Additionally,the study compared the clinical characteristics of primary liver cancer patients who received antiviral treatment and those who did not before admission,aiming to investigate the impact of antiviral therapy on the development of tumors and provide a certain reference for the diagnosis and treatment of primary liver cancer.MethodsClinical medical records of 1025 patients with Hepatitis B-related primary liver cancer were collected from the First Hospital of Lanzhou University from January 2014 to December 2021.The patients were divided into HBe Ag-positive group,HBe Agnegative group,HBe Ag/HBs Ag seroconversion group and previously infected group according to their serologic statuses,and the differences in demographic and sociological characteristics,laboratory parameter,tumor stage and treatment modalities were assessed in the four groups;The patients were divided into treated and untreated groups according to whether they received antiviral therapy before admission,and the differences in demographic characteristics,laboratory parameter,tumor stage and treatment modalities between the two groups were evaluated to explore the effect of previous antiviral treatment on the development of tumor.Results1.There were 827 males(80.7%)and 198 females(19.3%)in the study population of 1025 patients,and the ratio of males to females is 4.2 to 1.The average age was 54 years old,and the majority of people aged between 35 and 55 years old and >55 years old were 556 and 445,accounting for 54.2% and 43.4% of the total study population,respectively.The number of serological statuses effectively analyzed was 1012 cases.Among them,203(20.1%)were HBe Ag-positive,519(51.3%)were HBe Ag-negative,219(21.6%)were HBe Ag/HBs Ag seroconversion,and 71(5.0%)were previously infected.In Child-Pugh score grade,557 cases(54.3%)were classified as Grade A,383cases(37.4%)were classified as Grade B,and 85 cases(8.3%)were classified as grade C.Among the CNLC staging,252(24.6%)were stage Ia,108(10.5%)were stage Ib,17(1.7%)were stage IIa,126(12.3%)were stage IIb,215(21.0%)were stage IIIa,210(20.5%)were stage IIIb,and 97(9.5%)were stage IV.There were 27 cases(2.6%)in the very early stage(stage 0),81 cases(7.9%)in the early stage(stage A),46 cases(4.5%)in the middle stage(stage B),774 cases(75.5%)in the late stage(stage C),and97 cases(9.5%)in the terminal stage(stage D)of BCLC staging.A total of 850 cases of HBV-DNA quantification were effectively analyzed,of which the number of <500IU/ml was 243(28.6%),the number of 500-2000 IU/ml was 121(14.2%),and the number of ≥2000 IU/ml was 486(57.2%).In terms of tumor treatment modalities,a total of 222 cases(21.7%)took radical treatment modalities for liver cancer and 803cases(78.3%)took systemic anti-tumor treatment modalities.2.Comparative analysis of the four different serological statuses showed statistically significant differences in inflammatory indexes,biochemical indexes,coagulation indexes,HBV-DNA quantification,and tumor CNCL staging between the four groups.Patients with Hepatitis B-related primary liver cancer who were undergoing HBe Ag/HBs Ag seroconversion had worse liver function,and the levels of ALT,AST,GLO,ALP,and GGT,which reflect liver function,were the highest among the four groups,while the levels of CHE and ALB,which reflect liver regeneration and synthesis capacity,were the lowest among the four groups.3.Disordered multiple Logistic regression analysis showed that age and history of antiviral therapy were protective factors for Hepatitis B-related primary liver cancer under different serological states,while HBV-DNA quantity > 2000IU/ml was an independent risk factor.4.The comparative analysis between the antiviral treatment group and the untreated group showed that there was a statistically significant difference between the two groups in inflammatory indexes,biochemical indexes,coagulation indexes,HBVDNA quantification,CNLC staging,BCLC staging,and tumor treatment modalities,and antiviral treatment was negatively correlated with HBV-DNA quantification and CNLC staging,indicating that antiviral treatment can well suppress the inflammation level of the body,reduce HBV virus replication,improve liver function,delay the progression of disease,and strive for the chance of eradication for more liver cancer patients.Conclusions1.Hepatitis B-related primary liver cancer has a significant gender preponderance in males,and the age of onset is mainly middle-aged and elderly.At the time of first diagnosis,most patients’ tumors have progressed to the middle and late stages,thus losing the opportunity for radical surgery.2.Comparison of clinical characteristics of patients with hepatitis B-related primary liver cancer in different serological statuses revealed that patients who were undergoing HBe Ag/HBs Ag seroconversion had the worst liver function.Disordered multiple Logistic regression analysis revealed that age and antiviral therapy were common protective factors between groups,and HBV-DNA quantification > 2000IU/ml was a common risk factor between groups.3.Antiviral therapy can significantly inhibit inflammation,relieve liver function,and delay the occurrence and development of tumor,and antiviral therapy is negatively correlated with HBV-DNA quantification and tumor CNLC staging(P < 0.001).4.In clinical practice,antiviral therapy should be initiated as early as possible for CHB patients,and close follow-up of people with " HBs Ag,HBe Ab and HBc Ab positive " infection pattern and previous infections should not be neglected,and early screening of patients with hepatitis B-related primary liver cancer should be strengthened to strive for more aggressive treatment for patients.