Comparison of patients with hepatitis B virus‐associated hepatocellular carcinoma: Data from two hospitals from Turkey and China

Abstract

AimsThere are many studies on the incidence of hepatitis B virus (HBV)‐associated hepatocellular carcinoma (HCC), but very little is known about the HCC features in different populations. The study aimed to compare characteristics in two cohorts of patients with HBV‐associated hepatocellular carcinoma from Turkey and China.MethodsData on patients with HBV‐associated HCC diagnosed by imaging or liver biopsy were retrospectively collected from Shandong Provincial Hospital (n = 578) and Inonu University Hospital (n = 359) between January 2002 and December 2020, and the liver function and HCC characteristics were compared. Continuous variables were compared using Student's t‐test or Mann–Whitney U test and categorical variables were compared using the χ² test or Fisher's exact test.ResultsThe patients in the Turkish cohort had significantly worse Child‐Pugh scores (Child‐Pugh A: 38.3% vs. 87.9%; Child‐Pugh B: 40.3% vs. 11.1%; Child‐Pugh C: 21.4% vs. 1.0%; p < 0.001) and significantly higher levels of aspartate aminotransferase (66.5 [38.0−126.0] vs. 36.0 [27.0−50.0] IU/L; p < 0.001), alanine aminotransferase (47.5 [30.0−87.3] vs. 33.0 [24.0−45.0] IU/L; p < 0.001), total bilirubin (20.8 [13.7−39.3] vs. 17.9 [13.8−24.0] mg/dL; p < 0.001), and lower albumin levels (32.0 [26.0−39.0] vs. 40.0 [36.1−43.8] g/L; p < 0.001) than patients in Chinese cohort. The tumor characteristics showed the Barcelona Clinic Liver Cancer (BCLC) score (BCLC 1: 5.1% vs. 71.8%; BCLC 2: 48.7% vs. 24.4%; BCLC 3: 24.4% vs. 3.8%; BCLC 4: 21.8% vs. 0; all p < 0.001), maximum tumor diameter (5.0 [3.0−9.0] vs. 3.5 [2.5−6.0] cm; p < 0.001), alpha‐fetoprotein values (27.7 vs. 13.2 ng/mL; p < 0.001), and percentage of patients with portal vein tumor thrombus (33% vs. 6.1%; p < 0.001) were all significantly worse in the Turkish cohort compared with Chinese cohort.ConclusionsHBV‐associated HCC from the Turkish cohort had worse liver function and more aggressive clinical characteristics than patients from the Chinese cohort.