慢性肝炎病毒感染与胃癌高风险相关：一项系统评价和累积分析
Chronic Hepatitis Virus Infection Are Associated With High Risk of Gastric Cancer: A Systematic Review and Cumulative Analysis.
作者信息
Yang Yusha, Jiang Zufu, Wu Weizhou, Ruan Libin, Yu Chengyang, Xi Yuning, Wang Liling, Wang Kunpeng, Mo Jinggang, Zhao Shankun
机构信息
Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
Department of Urology, Maoming People's Hospital, Maoming, China.
出版信息
Front Oncol. 2021 Jul 8;11:703558. doi: 10.3389/fonc.2021.703558. eCollection 2021.
UNLABELLED
Mounting studies demonstrated both chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infection might be associated not only with an increased risk of hepatocellular carcinoma but also extrahepatic malignancies, i.e., gastric cancer (GC). However, a quantitative result addressing the association between HBV/HCV infection and GC development is scarce. A systematic search to identify the eligible studies was performed in four databases, including MEDLINE, EMBASE, Cochrane Library, and the PsychINFO. The relationship between HBV/HCV infection and the risk of GC was quantified by calculating the hazard ratio (HR) with a 95% confidence interval (CI). More methodologies of this study were available in the PROSPERO (ID: CRD42021243719). Thirteen included studies involving 7,027,546 individuals (mean age, 42.6-71.9 years) were enrolled in the pooled analyses. Two articles provided the clinical data of both HBV and HCV infections. The proportion of high methodological quality studies was 76.9% (10/13). Synthetic results from 10 eligible studies of HBV showed that HBV infection was associated with a significantly higher risk of GC when compared with the healthy controls without HBV infection (pooled HR, 1.26; 95% CI, 1.08-1.47; = 0.003; heterogeneity, = 89.3%; < 0.001). In line with this finding, the combined effect derived from five included studies of HCV also supported a significant positive association between chronic HBV infection and GC development (pooled HR, 1.88; 95% CI, 1.28-2.76; = 0.001; heterogeneity, = 74.7%; = 0.003). In conclusion, both chronic HBV and HCV infections were related to a high risk of GC. The plausible mechanisms underlying such association might be correlated to HBV/HCV infection-induced persistent inflammation, immune dysfunction, and cirrhosis.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (http://www.crd.york.ac.uk/PROSPERO), identifier (CRD42021243719).
未标注
越来越多的研究表明，慢性乙型肝炎病毒（HBV）和慢性丙型肝炎病毒（HCV）感染不仅可能与肝细胞癌风险增加有关，还与肝外恶性肿瘤有关，即胃癌（GC）。然而，关于HBV/HCV感染与GC发生之间关联的定量结果却很少见。我们在四个数据库中进行了系统检索，以确定符合条件的研究，这四个数据库包括MEDLINE、EMBASE、Cochrane图书馆和PsycINFO。通过计算危险比（HR）及其95%置信区间（CI）来量化HBV/HCV感染与GC风险之间的关系。本研究的更多方法可在PROSPERO（标识符：CRD42021243719）中获取。纳入荟萃分析的有13项研究，涉及7027546人（平均年龄42.6 - 71.9岁）。两篇文章提供了HBV和HCV感染的临床数据。方法学质量高的研究比例为76.9%（10/13）。10项符合条件的HBV研究的综合结果表明，与未感染HBV的健康对照相比，HBV感染与GC风险显著更高相关（合并HR，1.26；95%CI，1.08 - 1.47；P = 0.003；异质性，I² = 89.3%；P < 0.001）。与此发现一致，五项纳入的HCV研究得出的综合效应也支持慢性HCV感染与GC发生之间存在显著正相关（合并HR，1.88；95%CI，1.28 - 2.76；P = 0.001；异质性，I² = 74.7%；P = 0.003）。总之，慢性HBV和HCV感染均与GC的高风险相关。这种关联背后可能的机制可能与HBV/HCV感染诱导的持续性炎症、免疫功能障碍和肝硬化有关。
系统评价注册
PROSPERO（http://www.crd.york.ac.uk/PROSPERO），标识符（CRD42021243719）。
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