HBV感染与胰腺癌发病风险关系的荟萃分析

摘要

Objective To investigate the relationship between hepatitis B virus (HBV) infection and risk of pancreatic cancer.Methods Various English and Chinese language literature databases,including PubMed,Web of Knowledge,Embase,Cochrane Library and the Chinese National Knowledge Infrastructure,were searched for case-control studies comparing rates of HBV infection and pancreatic cancer.The RevMan metaanalysis software,version 5.0,was used to perform the meta-analysis of the 6 included studies.Results Compared with the control group,the pancreatic cancer group had a significantly higher rate of positivity for hepatitis B surface antigen (HBsAg) (8.87％ vs.5.86％,odds ratio (OR) =1.24,95％ confidence interval (CI):1.06 to 1.47,P =0.009) and a lower rate of patients never exposed to HBV (defined as HBsAg(-)/hepatitis B core antibody (anti-HBc)(-) (69.4％ vs.77.1％,OR =0.68,95％ CI:0.51 to 0.92,P =0.01).There was no significant difference between the two groups in the rate of hepatitis B e antigen positivity (P =0.55).Conclusion HBV-infected patients with HBsAg(+) status are at greater risk of developing pancreatic cancer; however,since most of the research studies evaluated were conducted in Asians,the generalizability of this conclusion is unknown.%目的 探索HBV感染与胰腺癌发病风险的关系.方法 检索了Pubmed、Web of knowledge、Embase、Cohchrane、万方数据、中国知网、维普全文数据库等,纳入HBV感染与胰腺癌发病风险有关的病例对照研究论文,并采用RevMan5.0软件对符合纳入标准的6个研究通过固定效应模型或随机效应模型进行荟萃分析.异质性用x2检验及I2检验评估;无统计学异质性,则采用固定效应模型进行分析,反之则采用随机效应模型.结果 荟萃分析结果显示:HBsAg的阳性率在胰腺癌组高于对照组(8.87％与5.86％,比值比为1.24,95％可信区间为1.06～ 1.47,P=0.009);未暴露于HBV的比例在胰腺癌组低于对照组(69.4％与77.1％,比值比为0.68,95％可信区间为0.51 ～ 0.92,P=0.01);而HBeAg阳性率差异无统计学意义(P=0.55).结论 HBsAg阳性的HBV感染者可导致胰腺癌的发病风险增加.但是,因可纳入的文献数量有限,以及纳入文献的研究人群主要以亚洲为主,以上结论需更多的研究证实.