| Objective:To investigate the correlation between schistosomiasis and hepatocellular carcinoma,and to analyze the clinicopathologic features of schistosomiasis related hepatocellular carcinoma and HBV related hepatocellular carcinoma and the influence of the difference of survival rate on prognosis.Methods:1.A total of 220 patients with liver cancer from October 2016 to December 2021 will be collected in this study,including 31 patients with schistosomiasis related liver cancer,183 patients with HBV related liver cancer,and 6 patients with schistosomiasis combined with HBV related liver cancer.Baseline data(gender,age,basic medical history,personal history)of each patient with liver cancer were collected.2.Basic clinicopathologic characteristics of schistosomiasis associated liver cancer and HBV associated liver cancer and schistosomiasis combined with HBV associated liver cancer were collected,respectively.3.The collected clinicopathologic characteristics of schistosomiasis related liver cancer,HBV related liver cancer,and schistosomiasis complicated with HBV related liver cancer were grouped according to sex,age,degree of differentiation,lymph node metastasis,nerve metastasis,vascular metastasis,presence of cirrhosis,depth of invasion,etc.4.The 3-year and 5-year follow-up data of patients with schistosomiasis related liver cancer and HBV-related liver cancer and schistosomiasis combined with HBV-related liver cancer were collected,and the patients with 3-year follow-up were divided into death group and survival group according to the outcome.5.Relevant statistical software was used to analyze the clinicopathological results.Results: Baseline clinical data: 31 patients with schistosomiasis related liver cancer,183 patients with HBV related liver cancer and 6 patients with schistosomiasis combined with HBV related liver cancer showed that the mean age of schistosomiasis related liver cancer group was higher than that of HBV related liver cancer group,with statistical difference(P=0.009).There were 20 males and 11 females in the schistosomiasis related liver cancer group,and 155 males and 28 females in the HBV related liver cancer group,with statistical difference(P=0.005).There were no statistical differences in smoking,hypertension,diabetes and chronic bronchitis among the three groups,including 1 case of Parkinson’s disease in the schistosomiasis related liver cancer group and 0 cases of HBV related liver cancer group(P=0.008).Analysis of clinicopathological data: There were 29 cases with low differentiation and 2 cases with high differentiation in schistosomiasis related hepatoma group,140 cases with low differentiation and 43 cases with high differentiation in HBV related hepatoma group.In schistosomiasis related liver cancer group,2 cases had nerve metastasis,29 cases had no nerve metastasis,and in HBV related liver cancer group,2 cases had nerve metastasis,181 cases had no nerve metastasis,the difference was not statistically significant(P > 0.05).In the schistosomiasis-related hepatocellular carcinoma group,there were 6 cases with vascular metastasis and 25 cases without vascular metastasis.There were 50 cases of vascular metastasis and 133 cases without vascular metastasis in HBV related liver cancer group,with no statistical significance(P > 0.05).There were 9 cases of cirrhosis(22 cases without cirrhosis)in schistosomiasis related liver cancer group,and 74 cases of cirrhosis(109 cases without cirrhosis)in HBV related liver cancer group,the difference was not statistically significant(P > 0.05).There were 5 cases(16.1%)with lymph node metastasis and 26 cases(83.9%)without lymph node metastasis in the schistosomiasis related liver cancer group.There were 0 cases(0%)with lymph node metastasis and 183 cases(100%)without lymph node metastasis in HBV related liver cancer group(P <0.001).In terms of the source of schistosomiasis related hepatocellular carcinoma cells,bile duct cells in 5 cases,liver cells in 26 cases,HBV-related hepatocellular carcinoma in 15 cases,liver cells in 168 cases,the difference was not statistically significant(P > 0.05).There were 5 cases(16.1%)of schistosomiasis related liver cancer,26 cases(83.9%)of T3-2,1 case(0.5%)of HBV related liver cancer,and 182 cases(99.5%)of T1-2 in the schistosomiasis related liver cancer group(P=0.001).Analysis of laboratory indicators: There was a statistically significant difference in the percentage of monocytes among HCC patients in the three groups(P=0.027).There was a significant difference in the number of erythrocytes among the three groups(P=0.012).There were statistically significant differences in the value of hemoglobin(P=0.012)and thrombin time among the three groups(P < 0.001).The mean value of carbohydrate antigen 199 in schistosomiasis liver cancer group was 220.84±408.30u/ml.The mean value of carbohydrate antigen 199 in hepatitis B liver cancer group was 40.48± 164.20u/ml,and the difference was statistically significant(P <0.001).There was no statistical difference in other laboratory indicators.Analysis of follow-up data: 9 patients died of schistosomiasis related liver cancer and 30 patients died of HBV related liver cancer.The average age of patients in schistosomiasis related liver cancer death group was 66.22±7.74 years old,and that in HBV related liver cancer death group was55.23±10.98 years old,the difference was statistically significant(P=0.008).There was no statistical difference in gender and smoking between the two groups.In the schistosomiasis related liver cancer death group,2 cases(22.2%)had lymph node metastasis,7 cases(77.8%)had no lymph node metastasis,and in the HBV related liver cancer group,0 cases(0%)had lymph node metastasis and 30 cases(100%)had no lymph node metastasis,the difference was statistically significant(P=0.049).There were 2 cases(22.2%)of schistosomiasis related hepatocellular carcinoma T3-4,7 cases(77.8%)of T1-2,0 cases(0%)of HBV related hepatocellular carcinoma T3-4,30 cases(100%)of HBV related hepatocellular carcinoma,the differences were statistically significant(P=0.049).There were no statistical differences in the degree of differentiation,nerve metastasis,vascular metastasis,cirrhosis and cell origin between the two groups.The five-year survival rate of schistosomiasis related liver cancer group was 51.7% lower than that of HBV related liver cancer group(77.2%,P=0.001).There was no significant difference in survival time and survival rate between the two groups.Conclusion:Both schistosomiasis and HBV infection are correlated with the occurrence and development of liver cancer.The prognosis of schistosomiasis related liver cancer is worse than that of HBV related liver cancer. |
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