中国高达85％的肝细胞癌（HCC）病例可以归因于乙型肝炎病毒（HBV）感染。脂质代谢在HBV相关肝癌的肝癌发生机制中起着重要作用。但是，有限的研究探讨了脂质代谢在HBV相关HCC中的预后作用。本研究建立了一个基于脂质代谢的预后模型以分层HBV相关HCC。根据癌症基因组图谱HBV相关HCC样本，本研究使用单变量和多变量Cox回归方法选择预后相关的脂质代谢基因，并建立了预后风险模型。最终用于建立模型的标记是通过最少绝对收缩和选择算子方法选择的。功能丰富分析、免疫景观和基因组改变分析被用于研究涉及预后的内在分子机制。该风险模型独立地将HBV感染的肝癌患者分成两组风险。低风险组具有更长的生存时间（P＜0.05，对数秩检验）。高风险组中发生TP53、LRP1B、TTN和DNAH8突变和高基因组不稳定性。低风险组具有更高的CD8 T细胞浸润和BTLA表达。脂质代谢（包括“脂肪酸代谢”）和免疫途径在低风险组中显著富集（P < 0.05）。本研究建立了一个强大的模型，有效地分层了HBV相关HCC。分析结果在一定程度上解码了HBV相关肝癌的异质性，并突出显示了HBV相关HCC中脂质代谢的扰动。本研究的发现有助于患者的临床分类，并为治疗选择提供线索。©2023年作者。

Up to 85% of hepatocellular carcinoma (HCC) cases in China can be attributed to infection of hepatitis B virus (HBV). Lipid metabolism performs important function in hepatocarcinogenesis of HBV-related liver carcinoma. However, limited studies have explored the prognostic role of lipid metabolism in HBV-related HCC. This study established a prognostic model to stratify HBV-related HCC based on lipid metabolisms.Based on The Cancer Genome Atlas HBV-related HCC samples, this study selected prognosis-related lipid metabolism genes and established a prognosis risk model by performing uni- and multi-variate Cox regression methods. The final markers used to establish the model were selected through the least absolute shrinkage and selection operator method. Analysis of functional enrichment, immune landscape, and genomic alteration was utilized to investigate the inner molecular mechanism involved in prognosis.The risk model independently stratified HBV-infected patients with liver cancer into two risk groups. The low-risk groups harbored longer survival times (with P < 0.05, log-rank test). TP53, LRP1B, TTN, and DNAH8 mutations and high genomic instability occurred in high-risk groups. Low-risk groups harbored higher CD8 T cell infiltration and BTLA expression. Lipid-metabolism (including "Fatty acid metabolism") and immune pathways were significantly enriched (P < 0.05) in the low-risk groups.This study established a robust model to stratify HBV-related HCC effectively. Analysis results decode in part the heterogeneity of HBV-related liver cancer and highlight perturbation of lipid metabolism in HBV-related HCC. This study's findings could facilitate patients' clinical classification and give hints for treatment selection.© 2023. The Author(s).