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Hepatitis B viral load and hepatic enzymes play an essential role in hepatocellular cancer advancement. In this research, we evaluated 1,940 HBV‐related HCC patients that undertook hepatectomy from 4 health centers in west China. Type 1 patients had the most effective diagnosis with 5‐year overall survival of 69. 8%, followed by type 2 and type 3 patients, whereas type 4 patients had the most awful diagnosis with 5‐year OS of 42. 7%. Pathologically, type 4 correlated with more sophisticated tumours taking into consideration tumour dimension and microvascular invasion than those in type 1, 2, or 3. Furthermore, type 4 patients had much more severe hepatic inflammation in underlying liver. Alternatively, type 1 patients had an active tumor immune microenvironment as shown by even more CD8+ T cell seepage and less PD‐L1 expression. In verdict, the classfication based on standard HBV‐DNA load and AST/ALT ratio might effectively stratify HBV‐related HCC patients with distinguishable diagnoses after hepatectomy.
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