Department of Gastroenterology, XinQiao Hospital or Biomedical Analysis Center Third Military Medical University, Chongqing 400037, People's Republic of China.
Cancer Causes Control. 2013 Mar;24(3):529-37. doi: 10.1007/s10552-012-0144-2. Epub 2013 Jan 10.
Hepatitis B virus (HBV) infection is reported to be associated with an increased risk of pancreatic cancer (PaC), but it remains controversial whether this is a causal relationship. In addition, it is unclear whether the status of HBV infection also affects PaC risk. Therefore, we conducted a meta-analysis to more closely examine the association between HBV infection and PaC.
The studies included in the meta-analysis were identified and retrieved from PubMed and several other databases. The literature search was conducted up until August 2012. We adopted the Cochrane Collaboration's RevMan 5.1 in a combined analysis of pooled relative risk (RR) with their corresponding 95 % confidence intervals (CIs) using a random-effects and a fixed-effects model.
Nine studies including 6 case-control and 3 cohort studies met eligibility criteria. The meta-analysis showed that the PaC risk was positively correlated with HBV infection when comparing with 'never exposed to HBV' subgroup, the pooled RR was 1.39 (95 % CI 1.22-1.59, p < 0.00001) in chronic HBV carriers, 1.41 (95 % CI 1.06-1.87, p = 0.02) in past exposure to HBV, and 3.83 (95 % CI 1.76-8.36, p = 0.0007) in active HBV infection. Using a stratified analysis, we also found that the risk of PaC was independent of smoking, alcohol drinking, and diabetes.
Findings from this meta-analysis strongly support that HBV infection is associated with an increased risk of PaC.
乙型肝炎病毒（HBV）感染与胰腺癌（PaC）风险增加相关，这一点已有报道，但这种关系是否具有因果关系仍存在争议。此外，HBV 感染状态是否也会影响 PaC 风险尚不清楚。因此，我们进行了一项荟萃分析，以更密切地观察 HBV 感染与 PaC 之间的关系。
通过从 PubMed 和其他几个数据库中检索，确定并纳入了荟萃分析中的研究。文献检索截至 2012 年 8 月。我们使用 Cochrane 协作 RevMan 5.1 软件，采用随机效应模型和固定效应模型，对汇总的相对风险（RR）及其相应的 95%置信区间（CI）进行合并分析。
共有 9 项研究符合纳入标准，包括 6 项病例对照研究和 3 项队列研究。荟萃分析显示，与“从未接触过 HBV”亚组相比，HBV 感染者的 PaC 风险呈正相关，慢性 HBV 携带者的汇总 RR 为 1.39（95%CI 1.22-1.59，p<0.00001），既往 HBV 感染者为 1.41（95%CI 1.06-1.87，p=0.02），活动性 HBV 感染者为 3.83（95%CI 1.76-8.36，p=0.0007）。采用分层分析，我们还发现 PaC 风险与吸烟、饮酒和糖尿病无关。
这项荟萃分析的结果强烈支持 HBV 感染与 PaC 风险增加相关。
