Underlying liver disease is correlated with hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV) infection. However, the impact of hepatic inflammation and fibrosis on the patients’ prognoses remains unclear. The clinicopathological data of 638 HBV-infected patients with early-stage HCC between 2017 and 2019 were prospectively collected. Hepatic inflammation and fibrosis were evaluated by experienced pathologists using the Scheuer score system. Survival analysis was analyzed using the Kaplan–Meier analysis. Application of the Scheuer scoring system revealed that 50 (7.9%), 274 (42.9%), and 314 (49.2%) patients had minor, intermediate, and severe hepatic inflammation, respectively, and 125 (15.6%), 150 (23.5%), and 363 (56.9%) patients had minor fibrosis, advanced fibrosis, and cirrhosis, respectively. Patients with severe hepatitis tended to have a higher rate of HBeAg positivity, higher HBV-DNA load, elevated alanine aminotransferase (ALT) levels, and a lower proportion of capsule invasion (all Pp < 0.05). There were no significant differences in the recurrence-free and overall survival among the three groups (P = 0.52 and P = 0.66, respectively). Patients with advanced fibrosis or cirrhosis had a higher proportion of HBeAg positivity and thrombocytopenia, higher FIB-4, and larger tumor size compared to those with minor fibrosis (all P < 0.05). Patients with minor, advanced fibrosis, and cirrhosis had similar prognoses after hepatectomy (P = 0.48 and P = 0.70). The multivariate analysis results indicated that neither hepatic inflammation nor fibrosis was an independent predictor associated with prognosis. For HBV-related HCC patients receiving antiviral therapy, hepatic inflammation and fibrosis had little impact on the post-hepatectomy prognosis.

中文翻译：

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肝脏炎症和纤维化对乙型肝炎病毒相关性肝细胞癌肝切除术后复发及长期生存的影响

乙型肝炎病毒 (HBV) 感染患者的潜在肝脏疾病与肝细胞癌 (HCC) 的发展相关。然而，肝脏炎症和纤维化对患者预后的影响仍不清楚。前瞻性收集2017年至2019年638例HBV感染的早期HCC患者的临床病理资料。肝脏炎症和纤维化由经验丰富的病理学家使用 Scheuer 评分系统进行评估。使用 Kaplan-Meier 分析进行生存分析。应用 Scheuer 评分系统显示，分别有 50 名（7.9%）、274 名（42.9%）和 314 名（49.2%）患者患有轻度、中度和重度肝脏炎症，125 名（15.6%）、150 名（23.5%）患者患有轻度、中度和重度肝脏炎症。 ），363 名患者（56.9%）分别患有轻度纤维化、晚期纤维化和肝硬化。重症肝炎患者的HBeAg阳性率、HBV-DNA载量、丙氨酸转氨酶（ALT）水平较高、包膜侵犯比例较低（均Pp < 0.05）。三组间无复发生存率和总生存率无显着差异（分别为 P = 0.52 和 P = 0.66）。与轻度纤维化患者相比，晚期纤维化或肝硬化患者 HBeAg 阳性和血小板减少的比例较高，FIB-4 较高，肿瘤体积较大（均 P < 0.05）。轻度、晚期纤维化和肝硬化患者在肝切除术后具有相似的预后（P = 0.48 和 P = 0.70）。多变量分析结果表明，肝脏炎症和纤维化都不是与预后相关的独立预测因素。对于接受抗病毒治疗的HBV相关HCC患者，肝脏炎症和纤维化对肝切除术后的预后影响不大。