Pang Qing, Qu Kai, Zhang Jingyao, Xu Xinsen, Liu Sushun, Song Sidong, Wang Ruitao, Zhang Lingqiang, Wang Zhixin, Liu Chang
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
J Gastroenterol Hepatol. 2015 Oct;30(10):1450-60. doi: 10.1111/jgh.12990.
Although the influence of cigarette smoking on the incident risk of liver cancer has been determined, the association between smoking and liver cancer mortality remains uncertain.
We searched Pubmed, EmBase, and Web of Science databases to obtain eligible studies. Hazard ratio (HR) value and 95% confidential intervals (CI) were pooled by using a random-effects model, and dose-response analyses were conducted to quantify associations between smoking and mortality from liver cancer.
A total of 27 articles involving four million participants from seven countries by retrieval (published 1986-2014) were finally included. Pooled HR values for liver cancer mortality was 1.45 (95% CI: 1.33-1.59), 1.22 (95% CI: 1.11-1.34) and 1.16 (95% CI: 1.01-1.32) for current, former, and ever smokers, respectively, when compared with nonsmokers. The risk increased by 7.1% (95% CI: 1.4-13.2) for per additional 10 cigarettes per day and by 5.2% (95% CI: 0.02-11.2) for per additional 10 pack-years. In our population recruiting 597 patients with liver cancer, smoking status was further identified as a significant determinant factor of tumor size and serum level of gamma-glutamyl transpeptidase, but not a significant prognostic factor.
Cigarette smoking, especially current smoking, significantly increased mortality risk from liver cancer.
尽管吸烟对肝癌发病风险的影响已得到确定，但吸烟与肝癌死亡率之间的关联仍不明确。
我们检索了PubMed、EmBase和Web of Science数据库以获取符合条件的研究。采用随机效应模型汇总风险比（HR）值和95%置信区间（CI），并进行剂量反应分析以量化吸烟与肝癌死亡率之间的关联。
最终纳入了通过检索得到的27篇文章，涉及来自7个国家的400万参与者（发表时间为1986 - 2014年）。与不吸烟者相比，当前吸烟者、既往吸烟者和曾经吸烟者的肝癌死亡率合并HR值分别为1.45（95%CI：1.33 - 1.59）、1.22（95%CI：1.11 - 1.34）和1.16（95%CI：1.01 - 1.32）。每天每增加10支香烟，风险增加7.1%（95%CI：1.4 - 13.2）；每增加10包年，风险增加5.2%（95%CI：0.02 - 11.2）。在我们招募的597例肝癌患者中，吸烟状况进一步被确定为肿瘤大小和γ-谷氨酰转肽酶血清水平的重要决定因素，但不是一个显著的预后因素。
吸烟，尤其是当前吸烟，显著增加肝癌死亡风险。
