关键词: HBV相关肝癌, 非病毒相关肝癌, 临床特征

Abstract: Objective To compare and analyze the clinical characteristics between patients with hepatitis B virus-related primary liver cancer (HBV-PLC) and non-virus related primary liver cancer (NBNC-PLC), and explore the mechanism of the differences, in order to provide a reference for the clinical diagnosis and treatment of PLC.Methods 47 cases of PLC patients hospitalized in the Department of Oncology, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from March 2018 to March 2021 were enrolled in this study, including 28 cases in the HBV-PLC group and 19 cases in the NBNC-PLC group. Patients in the NBNC-PLC group were both negative in hepatitis B viral surface antigen and hepatitis C viral antibody. The clinical data of these two groups of PLC patients were compared and analyzed.Results There was no significant difference in genders between the two groups (P>0.05). The onset age of HBV-PLC patients (60.97±12.18) was about 10 years younger than that of NBCC-PLC patients (69.28±11.73) (P<0.05). There were no significant differences in the numbers of tumors, formation of portal vein tumor embolus, tumor pathological classifications and lymphatic metastasis between the two groups (P>0.05). However, HBV-PLC was more likely to locate in the right lobe of liver, whereas NBNC-PLC was more likely to occur in the left lobe of liver (P<0.05). HBV-PLC was more likely to have distant metastasis than NBNC-PLC (P<0.05). HBV-PLC tended to have more hepatocellular carcinoma (HCC), while NBNC-PLC tended to have more cholangiocellular carcinoma (CC) (P<0.05). There was no significant difference between the differentiation degrees of the two groups (P>0.05). There was no significant difference in the TNM and BCLC stages between the two groups (P>0.05). In terms of liver function, total protein (TP), albumin (Alb), globumin (GLO), alkaline phosphatase (ALP), cholinesterase (CHE) and lactate dehydrogenase (LDH) levels were not significantly different between the two groups (P>0.05), but aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (D-BIL), indirect bilirubin (IBIL), total bile acid (TBA), γ-Glutamyl Transferase (GGT) levels and Child-Pugh grades were statistically different between the two groups (P<0.05). The liver function of HBV-PLC was relatively poorer. There were no significant differences in tumor markers of carcinoembryonic antigen (CEA), Carbohydrate antigens CA125, CA199 and CA724 between the two groups (P>0.05), but the serum alpha fetoprotein (AFP) in HBV-PLC group was significantly higher than that in NBNC-PLC group (P<0.05). In terms of coagulation function, prothrombin time (PT), international normalized ratio (INR) and thrombin time (TT) were longer whereas prothrombin time activity (PTA) and FIB were lower in HBV-PLC patients than those in NBNC-PLC patients (P<0.05). There was no significant difference in activated partial thromboplastin time (APTT) between these two groups (P>0.05).Conclusion HBV-PLC is mainly HCC, which occurs more often in younger age and locates in the right hepatic lobe, with a higher metastasis rate, higher serum alpha fetoprotein (AFP), and poorer liver function and coagulating function. In contrast, NBNC-PLC is mostly ICC, which occurs more often in elder patients and locates mostly in the left lobe of the liver, with a less metastasis rate, lower serum AFP, and better liver function and coagulating function.

Key words: hepatitis B virus-related primary liver cancer, non-virus-related primary liver cancer, hepatitis B virus surface antigen, hepatitis C virus antibody, clinical features