Analysis Of Prognostic Factors In Hepatocellular Carcinoma Paitents With Type 2 Diabetes Mellitus

Objective: To analyze the risk factors affecting the prognosis of patients with primary hepatocellular carcinoma retrospectively.Methods: The data of 419 patients with primary hepatocellular carcinoma in the third Hospital of Hebei Medical University from January2015 to December 2017 were analyzed retrospectively,including 94 patients with type 2 diabetes mellitus and 325 patients without type 2 diabetes mellitus.Use Propensity Scores Matching was conducted to reduce confounding bias between the groups.The survival rate was estimated by Kaplan-Meier method.The differences between the two groups were compared by Log-rank test.Univariate and multivariate Cox proportional hazard models were used to analyze the prognostic factors.Results: Multivariate analysis showed that type 2 diabetes mellitus(HR=2.271,95%CI 1.491～3.459)and Barcelona Clinic Liver Cancer(P< 0.05,HR>1)were independent predictors of survival in patients with hepatocellular carcinoma.Subgroup analysis: the 1-,2-and 3-year cumulative survival rates of type 2 diabetes mellitus with a history of less than 6 years(n =52)were significantly higher than those with a history of type 2 diabetes≥6 years(n=42),the difference was statistically significant(P=0.026).The 1-,2-and3-year cumulative survival rate between the group with glycosylated hemoglobin<7.3%(n=45)and the group with glycosylated hemoglobin A1c≥7.3%(n=49),the difference was not statistically significant(P=0.427).The 1-,2-and 3-year cumulative survival rates of metformin group were significantly higher than those of insulin group,sulfonylurea group and diet control group,the difference was statistically significant(P=0.003).Conclusions: Type 2 diabetes mellitus is an independent predictor of the prognosis of hepatocellular carcinoma.