The Study On The Clinical Characteristics And Prognostic Factors Of Hepatocellular Carcinoma In Recent Years

Objective:By the analysis of medical records of hospitalized patient,The study aims to explain the clinical characteristics tend of primary liver cancer in the first hospital of ShanXi Medical University in nearly 2 years and invesgate the factors affecting the survival periond of patients.Methods:By searching the case of primary liver cancer in the computer in our hospital from October 1,2014 to September 30,2016,we collect the clinical data from the Record room including demographic information,family history,special individual bad habits,past medical history,tumor pathology,imaging checks from January 1,2014-september30,2016.The descriptive statistical methods was used to describe the results,and SPSS19.0 software was used for statistical analysis.The difference was statistically significant with P <0.05.Results:(1)Among the 277 patients,there were 215 males and 62 females,male: female =3.47: 1.(2)The composition of liver cancer is different including 197 case of HBV-related Accounting for 71.1%,21 case of HCV-related in the percent of 2.5%,7 case of alcohol-related,1 case of HBV / HCV infection,2 case of HBV with alcoholic liverdisease,1 case of auto-immune liver cancer,54 cases of other causes.(3)Among these patients,they are always Accompanied by other medical history: 40 cases of diabetes,184 cases of liver cirrhosis,43 cases of hypertension,5 cases of CHD,17 cases of medication history.(4)In patients with hepatocellular carcinoma treated first,AFP positive(>200ng/ml)rate of 44%.The predictation on diagnosis have some limitations,need to explore a wider coverage of the marker.(5)About the HBV five markers: HBsAg HBeAb HBcAb positive in 71 cases accounting for 39.0%,HBsAg HBe Ag HBcAb positive in 21 cases of 24.3 percentage,HBsAg HBcAb positive in 48 cases of 10.6 percentage,HBsAg HBeAg positive in 2cases,HbsAb HbcAb positive in 5 cases,HBeAb HBcAb in 6 cases,HbeAb HBsAg HBc Ab positive in 1 case,HBeAb HbsAb HbcAb HBcAb positive in 1 case,HBc Ab,HBsAg,HBsAb,HBc Ab in 1 case.(6)Refering to the antiretroviral therapy before the diagnosis of PLC,30 cases have and166 caces have not who affecting HBV.With Hepatitis C infection,there are 3 cases of anti-virus and 17 cases of non-virus.In addition,there are 74 cases positive in the indexs of HBV DNA and 55 cases negative.(7)The initial diagnosis of liver cancer,Tumor occurs in the single leaf in 109 cases and multiple leaf in 89 cases.Between those ones,47 cases’ tummer tissue always grows in the right lobe of the liver,111 cases in the right lobe,5 cases in caudate lobe,6cases in Hilar and 38 cases in2 two liver lobes.(8)It is a single factor affecting the survival of patients that Liver function level,BMI,BCLC period,cancer tissue size,alpha-fetoprotein,with or without cirrhosis.(9)BMI,BCLC staging,cirrhosis and tumor size are independent factors affecting the survival of patients with liver cancer.BMI is a protecti ve factor,BCLC stage,cirrhosis,tumor size is a risk factor.(10)For patients with treatment indications,the survival rate of the combined treatment group was higher than that of the TACE group at 12 months,36 months and 60 months.The survival time of the comprehensive treatment group was longer than that of the TACE alone group.Conclusion:(1)The incidence of the Primary liver cancer has a certain gender differences,the proportion of men is high,and HBV infection is the main cause of the disease.Besides,HCV infection,drinking,autoimmune related diseses is another factors resulting in cancers.(2)The number of tummer is mostly single,mostly in the right lobe of the liver.(3) the relation between HBV virus replication and the occurrence of liver cancer:Although many patients having the HBeAg seroconversion occurred,they are still in the risk of liver cancer.Therefore,HBV-related liver cancer,even if the virological HBV DNA sustained inhibition,HBeAb serological conversion,still need to monitor the occurrence of liver cancer.(4)The positive rate of AFP(> 200 ng / ml)accounted for 44% in patients with newly diagnosed liver cancer,and AFP was not sensitive to the diagnostic marker of liver cancer.(5)For patients with liver cancer,to maintain a good nutritional status,to avoid decompensation of liver function,control tumor growth,cirrhosis of patients with active anti-liver fibrosis treatment,which can effectively extend the survival of patients.(6)For patients with indications of liver cancer,comprehensive treatment program can effectively improve the survival rate of patients.