Departments of Pharmacology.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
J Clin Gastroenterol. 2022 Jan 1;56(1):55-63. doi: 10.1097/MCG.0000000000001532.
Chronic hepatitis C virus (HCV) infection is associated with increased risk of hepatobiliary tract cancer. However, whether chronic HCV infection is also associated with elevated risk of other types of cancer is still unknown. This systematic review and meta-analysis was conducted in order to investigate whether chronic HCV infection is positively associated with esophageal cancer.
A systematic review was conducted using Embase and MEDLINE databases from inception to November 2019, with a search strategy that comprised the terms for "hepatitis C virus" and "cancer." Eligible studies were cohort studies consisting of patients with chronic HCV infection and comparators without HCV infection, and followed them for incident esophageal cancer. Hazard risk ratio, incidence rate ratio, relative risk or standardized incidence ratio of this association were extracted from each eligible study along with their 95% confidence intervals and were combined to calculate the pooled effect estimate using the random effect, generic inverse variance method.
A total of 20,459 articles were identified using this search strategy. After 2 rounds of independent review, 7 studies satisfied the inclusion criteria and were included in the meta-analysis. Chronic HCV infection was significantly associated with a higher incidence of esophageal cancer with the pooled relative risk of 1.61 (95% confidence interval: 1.19-2.17; I2=39%). The funnel plot was relatively symmetric which was not suggestive of publication bias.
This systematic review and meta-analysis demonstrated that there is a modest association between chronic HCV and incident esophageal cancer. However, more studies are needed to investigate the causality of this association.
慢性丙型肝炎病毒（HCV）感染与肝胆道癌的风险增加有关。然而，慢性 HCV 感染是否也与其他类型癌症的风险增加有关尚不清楚。本系统评价和荟萃分析旨在调查慢性 HCV 感染是否与食管癌的发生呈正相关。
使用 Embase 和 MEDLINE 数据库从建库至 2019 年 11 月进行系统评价，检索策略包括“丙型肝炎病毒”和“癌症”的术语。合格的研究是队列研究，包括慢性 HCV 感染的患者和无 HCV 感染的对照组，并对其进行食管癌的发病情况进行随访。从每个合格的研究中提取该关联的风险比、发病率比、相对风险或标准化发病率比及其 95%置信区间，并使用随机效应、通用倒数方差法合并计算汇总效应估计值。
使用该搜索策略共确定了 20459 篇文章。经过 2 轮独立审查，有 7 项研究符合纳入标准并纳入荟萃分析。慢性 HCV 感染与食管癌的发生率显著相关，合并相对风险为 1.61（95%置信区间：1.19-2.17；I2=39%）。漏斗图相对对称，提示不存在发表偏倚。
本系统评价和荟萃分析表明，慢性 HCV 与食管癌的发生之间存在适度的关联。然而，需要更多的研究来探讨这种关联的因果关系。
