S1 Data -

Background Whether the etiology of chronic liver disease (CLD) impacts the overall survival (OS) of patients with hepatocellular carcinoma (HCC) remains unclear. We aim to clarify this issue. Materials and methods Between 2011 and 2020, 3941 patients who were newly diagnosed with HCC at our institution were enrolled in this study. In patients with multiple CLD etiologies, etiology was classified using the following hierarchy: hepatitis C virus (HCV) > hepatitis B virus (HBV) > alcohol-related > all negative. All negative was defined as negative for HCV, HBV, and alcohol use disorder. Results Among 3941 patients, 1407 patients were classified with HCV-related HCC, 1677 patients had HBV-related HCC, 145 patients had alcohol-related HCC, and 712 patients had all-negative HCC. Using the all-negative group as the reference group, multivariate analysis showed that HBV is an independent predictor of mortality (hazard ratio: 0.856; 95% confidence interval: 0.745–0.983; p = 0.027). Patients with HBV-related HCC had superior OS compared with patients with other CLD etiologies (p<0.001). Subgroup analyses were performed, for Barcelona Clinic Liver Cancer (BCLC) stages 0–A (p<0.001); serum alpha-fetoprotein (AFP) levels≧20 ng/ml (p<0.001); AFP levels < 20 ng/ml (p<0.001); age > 65 years (p<0.001); and the use of curative treatments (p = 0.002). No significant difference in OS between HBV and other etiologies was observed among patients aged ≤ 65 years (p = 0.304); with BCLC stages B–D (p = 0.973); or who underwent non-curative treatments (p = 0.1). Conclusion Patients with HBV-related HCC had superior OS than patients with other HCC etiologies.背景：慢性肝病（chronic liver disease, CLD）的病因是否会影响肝细胞癌（hepatocellular carcinoma, HCC）患者的总生存期（overall survival, OS），目前尚不明确。本研究旨在阐明这一问题。 材料与方法：2011年至2020年，本机构新确诊为肝细胞癌的3941例患者纳入本研究。对于合并多种慢性肝病病因的患者，按以下优先级进行病因分类：丙型肝炎病毒（hepatitis C virus, HCV）感染 > 乙型肝炎病毒（hepatitis B virus, HBV）感染 > 酒精相关病因 > 全阴性组。全阴性组定义为HCV、HBV检测均为阴性且无酒精使用障碍。 结果：3941例患者中，1407例归类为丙型肝炎病毒相关肝细胞癌，1677例为乙型肝炎病毒相关肝细胞癌，145例为酒精相关肝细胞癌，712例为全阴性组肝细胞癌。以全阴性组为参照组，多因素分析显示，乙型肝炎病毒感染是患者死亡的独立预测因素（风险比：0.856；95%置信区间：0.745~0.983；P=0.027）。乙型肝炎病毒相关肝细胞癌患者的总生存期优于其他慢性肝病病因相关肝细胞癌患者（P<0.001）。亚组分析结果显示，在巴塞罗那临床肝癌（Barcelona Clinic Liver Cancer, BCLC）分期0~A期（P<0.001）、血清甲胎蛋白（serum alpha-fetoprotein, AFP）≥20 ng/ml（P<0.001）、AFP<20 ng/ml（P<0.001）、年龄>65岁（P<0.001）以及接受根治性治疗（P=0.002）的患者亚组中，上述差异均具有统计学意义。而在年龄≤65岁（P=0.304）、BCLC分期B~D期（P=0.973）或接受非根治性治疗（P=0.1）的患者亚组中，乙型肝炎病毒相关与其他病因相关肝细胞癌患者的总生存期无显著差异。 结论：乙型肝炎病毒相关肝细胞癌患者的总生存期优于其他病因相关肝细胞癌患者。