Hepatitis B virus infection increases the risk of cholangiocarcinoma: A meta-analysis and systematic review
Hepatitis B virus infection increases the risk of cholangiocarcinoma: A meta-analysis and systematic review
复制标题
DOI：
10.1111/j.1440-1746.2012.07207.x
复制
发表时间：
2012-10-01
影响因子：
4.1
通讯作者：
Gong, Jianping
中科院分区：
文献类型：
--
作者：
Li, Min;Li, Jinzheng;Gong, Jianping
背景与目的：大量研究表明，肝炎病毒感染可能与胆管癌（CC）有关。然而，B型肝炎病毒（HBV）感染与胆管癌，特别是肝内胆管癌（ICC）的关系仍存在争议。方法：检索PUBMED、EMBASE和Web of Science数据库，检索截止2011年9月的相关研究。使用随机效应模型计算合并风险估计值。通过亚组分析进行异质性的潜在来源。本荟萃分析共纳入18篇论文。结果如下：所有研究的合并风险估计显示，HBV感染个体中CC的风险在统计学上显著增加（率比[RR]：2.66; 95%置信区间[CI]：1.97，3.60）。与无HBV感染者相比，HBV感染者发生内CC（ICC）（RR：3.42; 95% CI：2.46，43.74）、肝外CC（OR：1.46; 95% CI：0.98，2.17）和CC（OR：2.03; 95% CI：1.15，3.56）的风险增加。在HBV感染和ICC风险的亚组分析中，亚洲人研究的合并风险估计值（RR：3.63; 95% CI：2.56，5.13）高于非亚洲人（RR：1.93; 95% CI：0.78，4.76）。Begg漏斗图和Egger检验显示无发表偏倚的证据。结论：这项荟萃分析表明，HBV与CC的风险增加有关，特别是对于ICC。HBV参与CC发病的机制有待进一步研究。
Background and Aim: A number of studies have shown that hepatitis virus infections may be associated with cholangiocarcinoma (CC). However, the relationship between hepatitis B virus (HBV) infection and CC, especially intrahepatic cholangiocarcinoma (ICC), is still controversial. Methods: Relevant studies were identified by searching PUBMED, EMBASE and Web of Science Datebases up to September 2011. Pooled risk estimates were calculated using a random-effects model. Potential sources of heterogeneity were performed by subgroup analyses. A total of 18 papers were included in this meta-analysis. Results: The pooled risk estimate of all studies showed a statistically significant increased risk of CC among individuals with HBV infection (rate ratio [RR]: 2.66; 95% confidence interval [CI]: 1.97, 3.60). Compared with those without HBV infection, persons with HBV infection had an increased risk of intra-CC (ICC) (RR: 3.42; 95% CI: 2.46, 43.74), extrahepatic CC (OR: 1.46; 95% CI: 0.98, 2.17), and CC (OR: 2.03; 95% CI: 1.15, 3.56). In a subgroup analysis of HBV infection and risk of ICC, the pooled risk estimate of studies in Asians (RR: 3.63; 95% CI: 2.56, 5.13) was higher than that in non-Asians (RR: 1.93; 95% CI: 0.78, 4.76). A Begg funnel plot and Egger test revealed no evidence for publication bias. Conclusions: This meta-analysis shows that HBV is associated with increased risk of CC, especially for ICC. Further investigation is needed to focus on the mechanism by which HBV may be involved in the pathogenesis of CC.