关键词: 原发性肝癌, 乙型肝炎, 危险因素, 生存期

Abstract: Objective To clarify the prognostic factors that influence the overall survival（OS）in patients with hepatitis B virus-related primary liver carcer（HBV-PLC）. Methods The clinical data of 119 patients with HBV-PLC from November 2011 to June 2014 in our hospital were retrospectively reviewed,and OS was analyzed by using Kaplan-Meier method,Log-rank test and Cox proportional hazard model. Results There were 41 cases （34.5%） with terminal stage of tumor [Barcelona Clinic Liver Cancer（BCLC）stage D ],79（66.4%） with Child-Pugh class C,78（65.5%） with pre-existing diseases,and 90（75.6%） with tumor metastasis among the 119 patients with HBV-PLC;The median overall survival in this series was 287（172,560） days,and the median overall survivals of patients with non-antiviral therapy,with antiviral therapy for less than one year,with antiviral therapy for one to three years,and with antiviral therapy for more than 3 years were 232（114,390） days,357（179,879） days,530 （206-）days,and 795（384,912） days （P<0.01）;The Cox proportional-hazards model demonstrated that nationality [relative risk（RR）=3.18,95% CI,1.71~5.91,P=0.000],Child-Pugh class（RR=1.60,95%CI,1.180~2.16,P=0.002）,tumor metastasis（RR=4.86,95%CI,2.72~8.68,P=0.000）,age（RR=1.82,95%CI,1.13~2.95,P=0.014）,antiviral therapy prior to diagnosis of HBV-PLC（RR=1.30,95%CI,1.00~1.69,P=0.048）,serum HBV DNA level （RR=5.88,95%CI,3.22~10.71,P=0.000）and the way targeting tumor therapy （RR=1.13,95%CI,1.01~1.26,P=0.025） were significant predictor of overall survival. Conclusion Many factors might influence the overall survival of patients with HBV-PLC,and the rigorous screening and surveillance in the HBV-infected populations,and effective antiviral therapy for HBV infection are important for prolonging the life of patients with PLC.

Key words: Primary liver cancer, Hepatitis B, Risk factors, Survival