| Objective:To investigate the epidemiology of primary liver cancer and clinical characteristics of HBV-related hepatocellular carcinoma in Yan ’an from January 2010 to December 2021,and to provide scientific basis for the prevention and treatment of chronic diseases and the government to formulate prevention and treatment measures for liver cancer.Materials and Methods: Retrospectively collected in January 2010-December 2021 at yan ’an university affiliated hospital and yan ’an people’s hospital of epidemiological data of 1101 patients with primary liver cancer（gender,age,family history of liver cancer,smoking,drinking history,history of diabetes,hypertension,fatty liver disease,birth and history of census register seat,virus infection,the leading cause of liver cancer,confirmed Age,time of diagnosis and cirrhosis）,by gender and time period（2010.01-2015.12 and 2016.1-2021.12）.Were collected from January 2010 to December2021 yanan university affiliated hospital of 557 patients with diagnosis of HBV related hepatocellular carcinoma for the first time the demographic characteristics of information（gender,age,family history of liver cancer,smoking,drinking history,diabetes history,history of hypertension,fatty liver,antiviral treatment,age of diagnosis,the diagnosis time and cirrhosis of the liver）and clinical information Materials（HBs Ag,HBs Ab,HBe Ag,HBe Ab,HBc Ab,HBV DNA,Child-Pugh grade,BCLC stage,tumor number,tumor size,NLR,PLR,ALB,GLB,ALT,AST,TBi L,DBi L,ALP,GGT,PT,PTA,AFP）and survival time were analyzed by HBV DNA and HDL level.Results: 1.Among 1101 patients with primary liver cancer,the male to female ratio was3.94 to 1,There were 8（0.73%）,40（3.63%）,216（19.62%）,411（37.33%）,275（24.98%）and 151（13.71%）patients aged <30 years,30-39 years,40-49 years,50-59 years,60-69 years and ≥70 years,respectively.This study showed that chronic HBV infection was the main risk factor in Yan ’an,with 907 cases（82.38%）of chronic HBV infection and 7cases（0.64%）of HBV/HCV overlapping infection.The incidence rates in Baota District,Zichang,Ansai,Yanchuan,Yanchang,Fuxian,Ganquan,Wuqi,Yichuan,Zhidan,Luochuan,Huanglong and Huangling were 0.566‰,0.574‰,0.656‰,0.730‰,0.746‰,0.574‰,0.897‰,0.269‰,0.464‰,0.309‰,0.094‰,0.121‰ and 0.024‰.There were statistically significant differences in age,smoking and drinking history and HBV chronic infection history among different gender groups（P<0.05）.There were statistically significant differences in age,cirrhosis,history of hypertension and history of diabetes in different time groups（P<0.05）,the probability of HBV antiviral history in HBV-related hepatocellular carcinoma patients from January 2010 to December 2015 was 21.48%,and the probability of HBV antiviral history in HBV-related hepatocellular carcinoma patients from January 2016 to December 2020 was 31.99%。2.Among the 557 patients with HBV-related hepatocellular carcinoma,456 were males and 101 were females.The male to female ratio was 4.51:1,and the proportions of<30 years old,30-39 years old,40-49 years old,50-59 years old,60-69 years old and≥70 years old were 1.26%,3.59%,22.80%,35.73%,25.85% and 11.47%,respectively.There were 51（9.16%）,172（30.88%）,85（15.26%）,177（31.78%）and 72（12.93%）BCLC stage 0,A,B,C,and D,respectively.Among the 557 patients with HBV-related hepatocellular carcinoma,256 patients had complete natural history of the virus,including 4 patients in immune tolerance stage（1.56%）,26 patients in immune clearance stage（10.16%）,56 patients in immune control stage（21.88%）,34 patients in reactive stage（13.28%）,127 patients in uncertain stage（49.61%）.9 cases（3.52%）recovered from hepatitis B.3.Among the 557 patients with HBV-related hepatocellular carcinoma,163 cases with complete hs HBV DNA data were divided into groups according to the size of hs HBVDNA,including 48 cases in the hs HBVDNA <10IU/ m L group and 55 cases in the hs HBVDNA 10-2000 IU/ m L group.60 patients with hs HBV DNA>2000IU/ml.The differences in demographic characteristics,clinical characteristics and cumulative survival were analyzed.Results: There were statistically significant differences in anti-HBV treatment history,fatty liver history,diabetes history,HBs Ag level,ALB,GLB,ALT,AST,ALP,GGT,PTA,AFP,BCLC stage,tumor number and tumor size among 3 groups（P<0.05）.Follow-up: 76 patients died,82 survived,and 5 lost until March 27,2022.The results showed that the median survival time of <10IU/ m L was 56months（95%CI 44.9-67.1）,and the 1-year,2-year and 3-year survival rates were 91.1%,77.7% and 69.2%,respectively.The median survival time was 23 months（95%CI17.5-28.5）in the 10-2000IU/ m L group,and the 1-year,2-year and 3-year survival rates were 61.4%,46.7% and 44.1%,respectively.The median survival time was 49 months（95%CI 23.3-74.7）in the >2000IU/ m L group.The 1-year,2-year and 3-year survival rates were 70%,58.2% and 52.7%,respectively.There was statistical difference between the <10IU/ m L group and the 10-2000 IU/ m L group（P=0.008）,but there was no statistical significance between the <10IU/ m L group and the >2000IU/ m L group or between the 10-2000 IU/ m L group and the >2000IU/ m L group（P>0.05）.4.Among 557 patients with HBV-related hepatocellular carcinoma,332 had complete HDL data.142 patients with HDL levels lower than 0.88mmol/L（low level group）and 190 patients with HDL levels between 0.88-2.04mmol/L（normal group）were included in the study.There was statistical significance in ALB,TBi L,DBi L,PT,PTA,NLR,PLR,Child-pugh grade and tumor size between the two groups（P<0.05）.Follow-up: As of March 27,2022,130 died,78 survived,and 124 lost to follow-up.The median survival time of patients with low HDL level was 17 months（95%CI 5.9-28.5）,and the 1-year,2-year and 3-year survival rates were 54.4%,40.8% and 35.6%,respectively.The median survival time of the normal HDL group was 39 months（95%CI9.9-58.3）,and the 1-year,2-year and 3-year survival rates were 69.7%,58.7% and 49.3%,respectively.The overall survival rate of the lower HDL group was better than that of the normal HDL group（P=0.017）.Conclusion:1.HBV infection is the main risk factor in Yan ’an.Compared with the previous 6years（2010.01-2015.12）,the anti-HBV treatment rate of HBV-related hepatocellular carcinoma patients in the latter 6 years（2016.01-2021.12）was higher overall,but the incidence of hypertension and diabetes increased.2.HBV DNA level affects the prognosis of HBV-related hepatocellular carcinoma patients: <10IU/ m L group has the best overall prognosis,while 10-2000IU/ m L group has the worst prognosis.3.HDL levels influence the prognosis of Patients with HBV-related hepatocellular carcinoma: patients with low HDL levels have worse prognosis than those with normal HDL levels. |
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