关键词: 基因3型丙型肝炎病毒, 肝细胞癌, Cox 回归模型, Kaplan-Meier 分析

Abstract: Objective To investigate the clinical characteristics and survival analysis of patients with genotype 3 (GT3) hepatitis C viral infection related hepatocellular carcinoma (HCV-HCC). Methods One hundred patients with GT3 HCV-HCC in the Third People′s Hospital of Kunming from January 2020 to December 2022 were collected in this study. According to the patient′s admission time and their outcomes in 2-year follow-up, the patients were divided into a death group and a survival group. The relevant clinical data, biochemical indicators, personal history, and other related indicators of these patients were collected. Univariate and multivariate Cox proportional hazards regression models were used to analyze the influencing factors of mortality in these patients with GT3 HCV-HCC. Receiver operating characteristic curve (ROC curve) and area under the curve (AUC) analysis was adopted. Survival curves for liver cancer were drawn using Kaplan Meier method with prothrombin time (PT), complications of ascites and bleeding as predictive indicators. Results There were 45 cases (45%) in the death group, and 55 cases (55%) in the survival group. According to the CNLC tumor staging system in China, there were 26 cases in stage I, 28 cases in stage II, 36 cases in stage III, and 10 cases in stage IV. According to the Child-Pugh grading system, there were 32 cases in stage A, 46 cases in stage B, and 22 cases in stage C. The results of Cox univariate and multivariate analysis showed that prothrombin time (PT) (HR=1.138, 95%CI 1.020~1.270, P=0.020), complication of peritoneal effusion (HR=1.414, 95%CI 1.016~1.970, P=0.040), and complication of bleeding (HR=1.901, 95% CI 1.337~2.704, P<0.001) were independent factors leading to mortality in patients with HCV-HCC. According to the ROC curve analysis, the maximum value of PT (AUC=0.763), the maximum value of complication of bleeding (AUC=0.797), the maximum value of complicaion of ascites (AUC=0.653), and the combined prediction of the three indicators for the maximum value (AUC=0.892). Conclusion PT, complication of ascites, and complication of bleeding are all risk factors affecting the survival of patients with GT3 HCV-HCC, and may serve as clinical indicators for predicting their prognosis.

Key words: Genotype 3 hepatitis C virus, Hepatocellular carcinoma, Cox regression model, Kaplan-Meier analysis