| Background: hepatitis B virus(HBV)is the leading cause of hepatocellular carcinoma(HCC).In the past few decades,due to the widespread implementation of HBV vaccination program and the application of potent antiviral drugs such as Entecavir and Tenofovir,the prevalence of HBV has decreased from high epidemic to medium epidemic and the morbidities of chronic hepatitis B(CHB)and HBV related HCC(HBV-HCC)have also been decreased overall.However,a study using GBD data showed that there were approximately 534,000 new cases of HCC worldwide in2019.Between 2010 and 2019,the global incidence of HCC increased by 27%,with39.4% of HCC cases occurring in China.In the past five years,the incidence of HBVHCC also appeared to show a slight upward trend in real-world clinical work due to population aging and changes in possible risk factors associated with liver disease.Therefore,HBV-HCC remains a real problem that needs urgent attention.Objective: This paper attempts to explore the characteristic trend of disease changes in HBV-HCC patients in the past decade and provide some reference for clinical prevention and treatment strategies.Methods: This is a single-center retrospective analysis.We collected clinical data of patients with HBV-HCC who were first hospitalized and diagnosed between January 2012 and December 2021.We divided the clinical data of all HBV-HCC patients in the last decade into two time periods for comparison,with the former time period(the first 5-year group)dominated by 2012 to 2016 and the latter time period(the second 5-year group)dominated by 2017 to 2021.We compared baseline differences between the two groups and further explored trends in disease characteristics in HBV-HCC patients.Results: A total of 1717 patients were recruited,510 in the first 5 years group and 1207 in the second 5 years group.Those diagnosed in the last five years were older(53.5y,P=0.002),more people smoked(17.0%,P=0.021),more people experienced antiviral therapy(20.6%,P=0.002),more people with family history of HCC(16.7%,P=0.024)and HBV family history(17.5%,P=0.003).There were more patients with low level viremia(HBVDNA<2000IU/ml)(38.8%,P=0.005)and more with abnormal ALT(69.1%,P=0.001)and AST levels(77.1%,P=0.014),more patients with liver fibrosis(79.5%,P<0.001)and cirrhosis(75.3%,P<0.001),more with metabolic syndrome(33.4%,P=0.001)than before.After adjusting for confounding factors,logistic regression analysis showed that patients diagnosed within the last five years were more likely to be affected by family history of HCC(OR=1.388,95%CI:1.013～1.901)and HBV(OR=1.626,95%CI:1.181～2.238)and accompanied with low-level viremia(OR =1.322,95% CI:1.046 ～1.671).There were more patients with abnormal ALT(OR = 1.545,95% CI:1.231 ～1.940)and AST level(OR =1.348,95% CI:1.054 ～1.725),so they might be exposed to more severe inflammatory environment.They had a greater chance of developing liver fibrosis(OR = 1.478,95% CI : 1.153 ～1.894)and cirrhosis(OR = 1.431,95%CI:1.128 ～1.815).In addition,they were more likely to develop MAFLD(OR = 1.455,95% CI:1.143 ～1.853).Conclusions: 1.The number of patients with HCC has increased in the last five years,the average age of diagnosis has increased,predominantly male and on the rise.2.Patients with HBV-HCC in the last five years were more likely to be affected by family history of HCC and HBV.They had a greater chance of developing more severe liver inflammation.They were more likely to be affected by liver fibrosis and cirrhosis.In the future,we still need to focus on high-risk population.In addition,They should also improve lifestyle,which may be more helpful for the prevention and treatment of HCC. |
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