Clinical outcome and prognosis analysis of liver lobectomy for HBV related hepatocellular carcinoma complicated with non-alcoholic fatty liver disease
10.3760/cma.j.cn115807-20231215-00192
- VernacularTitle:HBV相关肝细胞肝癌合并非酒精性脂肪肝肝叶切除临床转归及预后分析
- Author:
Junting LIU
1
;
Xiaoli WANG
;
Xiaochun ZHAO
Author Information
1. 长治医学院附属和济医院普外肝胆科，长治 046000
- Publication Type:Journal Article
- Keywords:
HBV related hepatocellular carcinoma;
Non-alcoholic fatty liver disease;
Liver lobectomy
- From:
Chinese Journal of Endocrine Surgery
2025;19(3):347-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical outcomes and prognosis of patients with HBV associated hepatocellular carcinoma (HCC) combined with non-alcoholic fatty liver disease (NAFLD) after liver lobectomy.Methods:113 HBV infected HCC patients (HBV HCC group), 113 HCC patients with concomitant NAFLD (NAFLD-HCC group) and 113 HCC patients with concomitant HBV infection and NAFLD (HBV/NAFLD-HCC group) who underwent liver lobectomy at Heji Hospital Affiliated to Changzhi Medical College from Jan. 2018 to Jan. 2021 were selected. All patients underwent radical liver lobectomy and were followed up every 3 months from the date of discharge. The clinical pathological parameters, surgical related indicators, postoperative complications, short-term and long-term prognosis of three groups of patients were compared. Logistic regression analysis was used to identify risk factors related to overall survival of HBV/NAFLD-HCC patients.Results:①Compared with patients in HBV-HCC group and NAFLD-HCC group, body mass index, ratio of combined basic diseases (hyperlipidemia, hypertension, diabetes), and maximum tumor diameter of patients in HBV/NAFLD-HCC group were significantly higher ( P<0.05). While the proportion of patients with liver cirrhosis in HBV HCC group was significantly higher than that in NAFLD-HCC group and HBV/NAFLD-HCC group ( P<0.05). ②There was no significant statistical difference ( P>0.05) among three groups of patients in terms of intraoperative vascular occlusion time, surgical time, intraoperative bleeding volume, blood transfusion volume, or postoperative hospitalization time. ③Compared with HBV-HCC and NAFLD-HCC groups, the incidence of postoperative complications (including postoperative bleeding, liver failure after hepatectomy, biliary fistula, subphrenic effusion, and pleural effusion) and the number of perioperative deaths in HBV/NAFLD-HCC group were significantly higher ( P<0.05). ④Compared with HBV-HCC group and NAFLD-HCC group, the postoperative recurrence rate of HBV/NAFLD-HCC group was significantly higher ( P<0.05), and the overall survival and relapse-free survival of HBV/NAFLD-HCC group were significantly shortened ( P<0.05). ⑤Multivariate Cox regression analysis showed that hyperlipidemia, hypertension, diabetes, cirrhosis, and the largest tumor diameter were risk factors affecting the overall survival of HBV/NAFLD-HCC patients ( P<0.05) . Conclusions:Compared with patients in HBV-HCC and NAFLD-HCC group, HBV/NAFLD-HCC patients have poorer postoperative complications and prognosis. Hyperlipidemia, hypertension, diabetes, cirrhosis, and tumor maximum diameter are risk factors affecting the overall survival of HBV/NAFLD-HCC patients.
