Study On The Relationship Between The Qualitative Of HBV DNA And Clinical Characteristics And Survival Time Of HBV-related HCC

Objective: To analyze the difference of clinical features between positive and negative HBV DNA in the initial diagnosis of HBV-related HCC,and to further analyze whether HBV DNA affects the survival time of the initial diagnosis of HBV-related HCC.To explore the relationship between HBV DNA and HBV of the progression and survival period of related primary liver cancer,and to provide clinical basis for the progression and antiviral treatment of HBV-related HCC.Methods: To gather the patients' information from December 2017 to June 2019 who has HBV-related HCC in Affiliated Hospital of Guilin Medical University.The first diagnosis of liver cancer was the starting time,death or December 2019 was the end time.According to the detection of serum HBV DNA in patients with primary diagnosis of liver cancer,the patients were divided into two groups: HBV DNA positive group and HBV DNA negative group.The general data of patients' sex,age,antiviral condition,blood sampling examination index,image data and survival after diagnosis of liver cancer were collected.Spss26.0 software was used to process the data,and chi square test was used to compare the counting data between the two groups;independent sample T test and Mann Whitney U test were used to measure the data;propensity score matching(PSM)was used to control the differences between groups of mixed variables,and the matched data used Kaplan Meier method to analyze the survival time.Log rank test was used to compare the survival curves between groups,P < 0.05 was set as the significant difference.Results:1.Among the 183 patients included in this study,130 were HBV DNA positive and 53 were HBV DNA negative,84.7% of them were male.For patients with liver cirrhosis,the proportion of Child-Pugh A and Child-Pugh B grades of HBV DNA-negative patients was higher than that of HBV DNA positive patients,and the proportion of Child-Pugh C grades of HBV DNA positive patients was more,the difference between Child-Pugh classification is statistically significant(P=0.018).In the comparison of liver function indexes,AST and AST / ALT levels in HBV DNA negative group were lower than those in HBV DNA positive group(All P values <0.05),and albumin levels were higher than those in HBV DNA positive group(P=0.012).There were more AFP ? 400 ug / L and HBe Ag positive patients in HBV DNA positive group(All P values <0.05).The tumor size of HBV DNA negative group was smaller than that of HBV DNA positive group(P=0.012),and the TNM stage was lower than that of HBV DNA positive group(P=0.021).2.After the HBV DNA positive and negative groups were matched for the propensity score,46 patients in the HBV DNA positive group and 46 patients in the HBV DNA negative group were matched.The median survival time was 11 months and 38 months.The median survival time of HBV DNA negative group was longer than that of HBV DNA positive group(P= 0.0098).Among the matched HBV DNA positive group patients,the 1-year and 3-year survival rates respectively were 62.5%,55.6% and 27.8%,5.6% in the antiviral group and the non-antiviral group.Difference in survival time between the two groups was significant(P=0.0001).Conclusions:1.In the first diagnosis of HBV-related HCC,there is a significant difference between the HBV DNA positive group and the negative group,and the patients who reach the antiviral pointer should be actively treated with antiviral therapy.2.The median survival time of the HBV DNA positive group in the first diagnosis of liver cancer was significantly lower than that in the HBV DNA negative group,among which the patients receiving antiviral treatment in the HBV DNA positive group had longer survival time than those without antiviral treatment.