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乙型肝炎病毒状态对肝内胆管癌结局的影响:一项荟萃分析。

Impact of viral hepatitis B status on outcomes of intrahepatic cholangiocarcinoma: a meta-analysis.

机构信息

Department of Liver Surgery, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, 1630 Dongfang Road, Shanghai, 200127, People's Republic of China.

International Co-operation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China.

出版信息

Hepatol Int. 2018 Jul;12(4):330-338. doi: 10.1007/s12072-018-9881-y. Epub 2018 Jun 26.

Abstract

BACKGROUND AND AIMS

To estimate the impact of viral hepatitis B status on outcomes of intrahepatic cholangiocarcinoma.

METHODS

We searched Pubmed and Embase for original articles that evaluated the impact of hepatitis B virus infection on outcomes of intrahepatic cholangiocarcinoma. The present study was conducted to generate odd ratios (ORs) with 95% confidence intervals (CIs) for pre-identified prognostic factors, overall survival, and recurrence.

RESULTS

From 438 studies, we identified eight articles that compared outcomes between hepatitis B virus-infected patients and the others. In terms of clinicopathological characteristics, patients in the hepatitis B virus group significantly demonstrated single nodular tumor (OR 0.7; 95% CI 0.5-0.9; p = 0.01), infrequent lymph node metastasis (OR 0.5; 95% CI 0.3-0.6; p < 0.01), and infrequent perineural infiltration (OR 0.3; 95% CI 0.2-0.8; p < 0.01). No significant between-group differences were found in tumor diameter, vascular invasion, and tumor differentiation. Previous or temporary infection (seropositivity for hepatitis B core antibody) revealed no significant impact on clinicopathological characteristics. For survival outcomes, meta-analysis demonstrated that hepatitis B virus group had significantly better overall survival, recurrence rate, and median survival (p < 0.01).

CONCLUSIONS

Our results suggest that hepatitis B virus infection is a powerful predictor of favorable survival outcomes for intrahepatic cholangiocarcinoma and significantly affects clinicopathological characteristics. Viral hepatitis B status needs to be taken into account and then establish therapeutic approaches.

摘要

背景与目的

评估乙型肝炎病毒状态对肝内胆管癌结局的影响。

方法

我们在 Pubmed 和 Embase 中搜索评估乙型肝炎病毒感染对肝内胆管癌结局影响的原始文章。本研究旨在生成预先确定的预后因素、总生存率和复发率的比值比(OR)及其 95%置信区间(CI)。

结果

从 438 项研究中,我们确定了 8 项比较乙型肝炎病毒感染患者与其他患者结局的文章。在临床病理特征方面,乙型肝炎病毒组患者的肿瘤呈单结节状(OR 0.7;95%CI 0.5-0.9;p = 0.01)、淋巴结转移频率较低(OR 0.5;95%CI 0.3-0.6;p < 0.01)和神经周围浸润频率较低(OR 0.3;95%CI 0.2-0.8;p < 0.01)。肿瘤直径、血管侵犯和肿瘤分化在两组间无显著差异。既往或暂时感染(乙型肝炎核心抗体阳性)对临床病理特征无显著影响。生存结局的荟萃分析表明,乙型肝炎病毒组的总生存率、复发率和中位生存时间显著更好(p < 0.01)。

结论

我们的结果表明,乙型肝炎病毒感染是肝内胆管癌生存结局的有力预测因子,并显著影响临床病理特征。需要考虑病毒肝炎 B 状态,然后制定治疗方法。

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