Analysis Of The Clinical Features Of Hepatitis B And Alcohol Related Primary Carcinoma Of The Liver

Objective: Through the analysis of the clinical features of hepatitis B virus and alcohol related primary carcinoma of the liver patients diagnosis on clinical,and provides some theoretical and practical basis for the clinical treatment of such patients,contribute to the early prevention and treatment of primary carcinoma of the liver(PLC),has a certain clinical value for improving the survival of patients the quality of life.Methods: Analysis of the clinical data of patients who were first diagnosed 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC in Ruikang hospital affiliated to Guangxi university of traditional Chinese medicine from June 2013 to June 2016.The clinical data and laboratory data of related hepatitis B virus related PLC,including gender,age,antiviral treatment history,drinking history,The history of liver fluke infection,History of liver cirrhosis,clinical symptoms(abdominal pain,abdominal distension,diarrhea,weight loss),signs(jaundice,ascites,hepatomegaly),clinical pathological type(massive type,nodular type and diffuse type),histological pathological types(liver cells type,bile duct cell type,mixed type),hepatitis B virus(HBV)infection,hepatitis B virus DNA(HBV-DNA),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),alpha fetoprotein(AFP),prothrombin time(PT),Child-Pugh classification.The clinical data and laboratory data of alcohol related PLC,including gender,age,drinking history,The history of liver fluke infection,History of liver cirrhosis,clinicalsymptoms(abdominal pain,abdominal distension,diarrhea,weight loss),signs(jaundice,ascites,hepatomegaly),clinical pathological types(massive type,nodular type and diffuse type),histological pathological types(liver cells type,bile duct cell type,mixed type),TBIL,ALT,AST,ALB,AFP,PT,Child-Pugh classification.All patients were screened by inclusion criteria and exclusion criteria for 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC in this study.500 cases of hepatitis B virus related PLC are used as case group,57 cases of alcohol related PLC are used as control group.The clinical data were statistically analyzed by statistical software SPSS 17.0.Results:(1)In 500 cases of hepatitis B virus related PLC,425 cases of male(accounted for 85.0%),75 cases of women(accounted for 15.0%),the ratio of male to female was 17:3(425 cases: 75 cases);In 57 cases of alcohol related primary carcinoma of the liver,57 cases of male(accounted for100.0%),0 cases of women(accounted for 0.0%),the ratio of men to women was 57:0(57 cases:0 case).(2)The age of onset of 500 cases of hepatitis B virus related PLC was15 years old to 86 years old,the average age(52.506 ±12.198)years old,A high incidence of age from 40 to 59 years,age of the youngest was 15 years old,at the age of 30 to 12 cases(accounted for2.40%),the age of onset is younger and younger;the age of onset of 57 cases of alcohol related PLC was 40 years old to 91 years old,the average age(58.509 ±10.924)years old,A high incidence of age from 50 to 69 years;statistically significant age differences were compared between the two groups(P < 0.05).The difference of age in the two groups was statistically significant(P < 0.05).(3)In 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC,the difference between drinking history and family history of PLC was statistically significant(P< 0.05);There was no statistical difference between the history of liver fluke infection and the history of liver cirrhosis(P > 0.05).(4)In 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC,The clinical manifestations of the first diagnosis were abdominal pain,diarrhea,abdominal distension,emaciation,jaundice,ascites,and lhepatomegaly,and the clinical manifestations were mainly abdominal pain and abdominal distension.There was no statistical difference between the two groups(P > 0.05).(5)In 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC,There was no significant difference in clinical pathological type and histological pathological types(P > 0.05).The most common pathological types were massive type and hepatocyte type.(6)In 500 cases of hepatitis B virus related PLC and 57 cases of alcohol related PLC,There was significant difference in ALT?AST?PT?ALB?AFP?Child-Pugh classification(P<0.05);There was no significant difference in TBIL(P > 0.05).(7)In 500 cases of hepatitis B virus related PLC,There was most common in HBsAg(+)HBeAb(+)HBcAb(+)(small San yang),followed by HBsAg(+)HBeAg(+)HBcAb(+)(big three yang).The positive rate of HBV DNA in the "small three yang" patients is much lower than that of the "big three yang" patients.(8)In 500 cases of hepatitis B virus related PLC,There was 231 cases(accounted for 46.2%)in the history of antiviral treatment for hepatitis B,and 269 cases(accounted for 53.8%)without antiviral treatment.HBV DNApositive(HBV DNA > 1000 IU/ml)was 268 cases(accounted for 53.6%),and HBV DNA negative(HBV DNA was less than 1000 IU/ml)was 232cases(accounted for 46.4%).Conclusion:(1)The age of hepatitis B virus related PLC is high from 40 to 59 years old.The age of alcohol related PLC is high from 50 to 69 years old.The age of onset of B virus related PLC is earlier than that of alcohol related PLC,and the age of onset is younger.(2)HBV chronic persistent infection and alcohol consumption are the risk factors of PLC,which can aggravate liver damage and lead to the occurrence of PLC.(3)The main clinical symptoms of hepatitis B and alcohol related PLC are abdominal pain and abdominal distension,but chronic gastritis,peptic ulcer,hepatitis,cirrhosis and cholecystitis can cause abdominal pain and abdominal distention.Therefore,we should pay attention to identify the causes of abdominal pain and abdominal distension and prevent missed diagnosis.(4)Hepatitis B virus related PLC of the negative HBV DNA of proportion is high,no antiviral treatment in patients with a history of proportion is also high,the reason may determine HBV DNA value for this research by using real-time quantitative PCR method,this method can only detect HBV DNA levels greater than 1000 IU /ml,and can not detect HBV DNA levels less than 1000 IU/ml.Therefore,the negative HBV DNA(HBV DNA?1000 IU/ml)still exists in HBV replication,clinicians often ignore the negative HBV DNA(HBV DNA?1000 IU/ml)in patients undergoing antiviral therapy,which leads to the deterioration and progress of hepatitis B disease.However,the detection methods usually used in clinic can onlydetect HBV DNA level greater than 1000 IU/ml,but can not detect HBV DNA level less than 1000 IU/ml.Therefore,the method of detecting HBV DNA usually can not meet the clinical needs.