Distinct clinical features and prognostic factors of hepatitis C virus-associated non-Hodgkin's lymphoma: a systematic review and meta-analysis.
Distinct clinical features and prognostic factors of hepatitis C virus-associated non-Hodgkin's lymphoma: a systematic review and meta-analysis.
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丙型肝炎病毒相关非霍奇金淋巴瘤的独特临床特征和预后因素：系统评价和荟萃分析
DOI：
10.1186/s12935-021-02230-1
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发表时间：
2021-10-09
影响因子：
5.8
通讯作者：
Huang H
中科院分区：
文献类型：
--
作者：
Zhang M;Gao F;Peng L;Shen L;Zhao P;Ni B;Hou J;Huang H
越来越多的证据表明，丙型肝炎病毒（HCV）感染与非霍奇金淋巴瘤（NHL）有关。然而，尚未就HCV相关NHL患者的临床特征和有效治疗达成明确共识。因此，我们进行了系统回顾和荟萃分析，以探讨抗病毒治疗或利妥昔单抗管理的临床特点和有效性的NHL患者HCV感染。检索了截至2021年7月31日的8个电子数据库，包括PubMed、奥维德、EMBASE、科克伦图书馆、ClinicalTrials、万方、CNKI和VIP，以查找符合条件的研究。计算对应于95%置信区间（CI）的风险比（HR）或比值比（OR），以估计结局。通过Egger和Begg检验评估发表偏倚。使用RevMan 5.4软件和Stata版本15进行统计分析。在当前荟萃分析中纳入的13，368例NHL患者中，有27篇入围文章。我们的研究结果表明，HCV感染的NHL患者的总生存期明显缩短，（OS：HR 1.89; 95% CI 1.42-2.51，P < 0.0001）和无进展生存期（PFS：HR 1.58; 95% CI 1.26-1.98，P < 0.0001），总体缓解率较低（ORR：OR 0.58，95%CI 0.46-0.73，P < 0.00001），化疗期间肝功能损害发生率较高（OR 5.96; 95% CI 2.61-13.62，P < 0.0001）。HCV阳性NHL患者表现出疾病晚期、LDH水平升高、IPI/FLIPI高-中-高风险以及脾和肝受累的发生率较高。此外，抗病毒治疗延长了生存期（OS：HR 0.38; 95% CI 0.24-0.60，P < 0.0001），疾病进展减少[PFS/DFS（无病生存期）：HR 0.63; 95% CI 0.46-0.86，P = 0.003]，并加强了治疗反应（ORR：OR 2.62，95%CI 1.34-5.11，P = 0.005）。最后，利妥昔单抗给药与良好的OS相关，而肝硬化和低水平的白蛋白预示着HCV阳性NHL患者的OS较差。目前的研究提供了令人信服的证据表明，HCV相关NHL患者的预后较差，临床特征明显。抗病毒治疗和含利妥昔单抗的方案被证明是有效的，在改善HCV感染的NHL患者的临床结果。在线版本包含补充材料，可通过10.1186/s12935-021-02230-1获得。
Increasing evidence suggests that hepatitis C virus (HCV) infection is associated with non-Hodgkin’s lymphoma (NHL). However, no clear consensus has been reached about the clinical features and effective treatment of HCV-associated NHL patients. We therefore performed a systematic review and meta-analysis to explore the clinical characteristics and effectiveness of antiviral treatment or rituximab administration among NHL patients with HCV infection. Eight electronic databases, including PubMed, OVID, EMBASE, Cochrane Library, ClinicalTrials, WANFANG, CNKI, and VIP, were searched for eligible studies up to July 31, 2021. The hazard ratio (HR) or odds ratio (OR) corresponding to the 95% confidence interval (CI) was calculated to estimate the outcomes. Publication bias was assessed by Egger’s and Begg’s tests. Statistical analysis was performed with RevMan 5.4 software and Stata version 15. There were 27 shortlisted articles out of a total of 13,368 NHL patients included in the current meta-analysis. Our results demonstrated that NHL patients with HCV infection had a significantly shorter overall survival (OS: HR 1.89; 95% CI 1.42–2.51, P < 0.0001) and progression-free survival (PFS: HR 1.58; 95% CI 1.26–1.98, P < 0.0001), a lower overall response rate (ORR: OR 0.58, 95% CI 0.46–0.73, P < 0.00001) and a higher incidence of hepatic dysfunction during chemotherapy (OR 5.96; 95% CI 2.61–13.62, P < 0.0001) than NHL patients without HCV infection. HCV-positive NHL patients exhibited an advanced disease stage, an elevated level of LDH, a high-intermediate and high IPI/FLIPI risk as well as a higher incidence of spleen and liver involvement. Moreover, antiviral treatment prolonged survival (OS: HR 0.38; 95% CI 0.24–0.60, P < 0.0001), reduced disease progression [PFS/DFS (disease-free survival): HR 0.63; 95% CI 0.46–0.86, P = 0.003] and reinforced the treatment response (ORR: OR 2.62; 95% CI 1.34–5.11, P = 0.005) among the HCV-infected NHL patients. Finally, rituximab administration was associated with a favourable OS, while liver cirrhosis and low levels of albumin predicted a poor OS for HCV-positive NHL patients. The current study provided compelling evidence about an inferior prognosis and distinct clinical characteristics among HCV-associated NHL patients. Antiviral treatment and rituximab-containing regimens were shown to be efficacious in improving the clinical outcomes of NHL patients with HCV infection. The online version contains supplementary material available at 10.1186/s12935-021-02230-1.
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影响因子：
3
作者：
Elbedewy, Tamer A.;Elashtokhy, Hossam Eldin A.;Suliman, Marwa A.
通讯作者：
Suliman, Marwa A.
影响因子：
50.5
作者：
Arcaini, L.;Burcheri, S.;Lazzarino, M.
通讯作者：
Lazzarino, M.
影响因子：
29.4
作者：
Pal, S;Sullivan, DG;Gretch, DR
通讯作者：
Gretch, DR
影响因子：
6.4
作者：
Hosry, Jeff;Mahale, Parag;Torres, Harrys A.
通讯作者：
Torres, Harrys A.
影响因子：
3.7
作者：
Canioni, Danielle;Michot, Jean-Marie;Besson, Caroline
通讯作者：
Besson, Caroline