Hepatocellular carcinoma: current trends in worldwide epidemiology, risk factors, diagnosis and therapeutics

Clinical characteristics of patients with hepatitis B virus related liver cirrhosis and primary liver cancer

AIM: To investigate the clinical characteristics of hepatitis B virus (HBV) related liver cirrhosis patients with primary liver cancer (PLC), in order to provide evidence for the prevention and early diagnosis of PLC.

METHODS: A total of 187 patients with HBV related liver cirrhosis and PLC and 318 patients with HBV related liver cirrhosis only were included in this study. Serological markers of HBV (HBV-M) were detected using enzyme linked immunosorbent assay (ELISA). HBV DNA was detected by quantitative polymerase chain reaction (PCR), and liver function was detected using an automatic biochemistry analyzer. The difference in clinical features between the two groups of patients was analyzed statistically.

RESULTS: In the PLC group, there were 156 men and 31 women, the proportion of male patients was higher than that of female patients (5.03:1), and the percentage of patients more than 40 years old was higher (87.83%). The main serological pattern in the PLC group was hepatitis B surface antigen (HBsAg), hepatitis B e antibody (HBeAb) and hepatitis B core antibody (HBcAb) positivity. HBV DNA positive rate in the PLC group was significantly lower than that in the HBV related liver cirrhosis alone group (75.31% vs 85.85%, P < 0.05). HBV DNA level in the PLC group was also significantly lower than that in the HBV related liver cirrhosis alone group (4.73 log₁₀IU/mL ± 1.26 log₁₀IU/mL vs 5.47 log₁₀IU/mL ± 1.35 log₁₀IU/mL, P < 0.05). The difference in the hepatitis B e antigen (HBeAg) conversion rates between < 40, 40-60 and > 60 years old groups had no statistical significance (P > 0.05). The differences in alanine aminotransferase (ALT), total bile acid (TBA), total bilirubin (TB), globulin (GLB), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and alpha-fetoprotein (AFP) levels were statistically significant between the two groups (P < 0.05).

CONCLUSION: HBV related liver cirrhosis patients who are male, more than 40 years old, HBeAb positive or have a low level of HBV DNA should be paid more attention for early screening of primary liver cancer. The combined detection of GGT, ALP and AFP could facilitate the early diagnosis of PLC.