Analysis Of Prognostic Factors After TACE By Baseline Datas Of HBV-associated Primary Liver Cancer Patients

Objective:The clinical situation and prognostic factors were analyzed,through the baseline data of patients with Hepatitis B virus（HBV）-associated primary liver cancer who treated with transarterial chemoembolization（TACE）in our center.In order to provide a more objective criteria for further evaluation of patients’ prognosis.Method:A total of 130 newly diagnosed HBV-associated primary liver cancer patients treated by TACE from 2017 to 2019 in the First Hospital of Lanzhou University were collected.The age,gender and prevalence of hypertension and diabetes,methods of anti-HBV drug taking,HBV DNA load,tumor-related serum markers and imaging examinations were described.The characteristics of baseline data of patients with portal vein tumor thrombus and metastasis were described respectively,the prognostic factors were analyzed by COX regression.The prognosis of patients was predicted by Barcelona clinic liver cancer（BCLC）and China liver cancer staging（CNLC）according to the follow-up data and their predictive value was compared at different time periods.Results:In this study,the sex ratio of men to women was 4.65 and the mean age of patients was 56.58±10.10 years old in 130 patients.49（37.70%）patients had received regular antiviral therapy before diagnosis.The average age of patients with metastasis was 53.84±11.04 years old,and the average age of patients without metastasis was57.71±9.52 years old（P<0.05）.The average age of patients with main portal vein tumor thrombus was 51.29±7.96 years old,the average age of patients with branch portal vein thrombus was 58.06±13.19 years old,and the average age of patients without thrombus was 57.10±8.80 years old（P<0.05）.The difference in tumor burden score（TBS）between patients with metastasis and different portal vein thrombus was statistically significant（P<0.05）.In multivariate analysis with Cox regression,portal vein involvement,extrahepatic metastasis,albumin-bilirubin（ALBI）and TBS scores,highdensity lipoprotein（HDL）had significant difference in patients’ prognosis（P<0.05）.The area under the ROC curve of BCLC stage at 12 months,24 months,and 36 months for the prediction of postoperative overall survival（OS）was 0.77（95%CI: 68.83%-84.51%）,0.84（95%CI: 77.28%-90.40%）,0.87（95%CI: 80.65%-94.05%）.The area under the ROC curve of CNLC stage for predicting postoperative OS of patients at 12 months,24 months and 36 months was 0.81（95%CI: 72.22%-88.80%）,0.87（95%CI:81.02%-93.19%）,0.89（95%CI: 82.92%-94.42%）.The area under the ROC curve of CNLC was larger than that of BCLC stage at 12 months and 24 months（P<0.05）,and there was no significant difference in the area under the ROC curve of the two staging system at 36 months（P>0.05）.Conclusion: In this study,the majority HBV-associated primary liver cancer patients who treated with TACE are middle-aged men,and most patients did not receive antiviral treatment before diagnosis.Patients with metastases or portal trunk thrombosis were younger and had higher TBS scores.ALBI,TBS score,portal vein tumor,metastasis are independent risk factors for prognosis,while HDL is a protective factor for prognosis.BCLC and CNLC stage both have predictive effects on the prognosis of HBV-associated primary liver cancer after TACE,but CNLC stage is superior to BCLC stage in terms of discrimination.