Division of Prevention, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Clinical Research Centers for Medicine, International University of Health and Welfare, Tokyo, Japan.
Sci Rep. 2023 Mar 1;13(1):3445. doi: 10.1038/s41598-023-30467-5.
In Japan, hepatocellular carcinoma (HCC) is a leading cause of cancer mortality and hepatitis C virus infection is a major cause of HCC. We conducted a systematic review and meta-analysis of published studies evaluating patient response to antiviral therapy for chronic hepatitis C on the risk of HCC occurrence in Japan. Articles were searched using terms determined a priori through PubMed, screened by title and abstract, and selected by full-text assessment according to criteria determined a priori, including HCC occurrence in response to interferon (IFN)-based or IFN-free therapy, Japanese study, and 2 or more years of follow-up. We excluded studies on HCC recurrence. We calculated the pooled estimate of the crude incidence rate ratio with data from the selected studies using the person-years method with Poisson regression model and pooled estimate of the hazard ratio adjusted for potential confounders reported by the studies using a random effects model. A total of 26 studies were identified, all of which examined only IFN-based therapy as a result of the selection process. The pooled estimate (95% confidence interval [CI]) of 25 studies was 0.37 (0.33-0.43) for sustained virologic response (SVR) and 1.70 (1.61-1.80) for non-SVR for the HCC incidence rate per 100 person-years, and 0.22 (0.19-0.26) for the incidence rate ratio (SVR vs. non-SVR). The pooled estimate of the hazard ratio (95% CI) of HCC incidence adjusted for potential confounders of 8 studies was 0.25 (0.19-0.34). SVR to interferon therapy for chronic hepatitis C reduces the risk of HCC occurrence.
在日本，肝细胞癌（HCC）是癌症死亡的主要原因，而丙型肝炎病毒感染是 HCC 的主要病因。我们对评估慢性丙型肝炎抗病毒治疗患者对 HCC 发生风险反应的已发表研究进行了系统评价和荟萃分析。使用通过 PubMed 预先确定的术语进行了文章检索，通过标题和摘要进行了筛选，并根据预先确定的标准通过全文评估进行了选择，包括对干扰素（IFN）为基础或无 IFN 治疗的反应、日本研究以及 2 年以上的随访发生 HCC。我们排除了关于 HCC 复发的研究。我们使用泊松回归模型的人选年法和研究报告的经潜在混杂因素调整的合并危险比（HR）的随机效应模型，对入选研究的数据进行了汇总估计。总共确定了 26 项研究，由于选择过程，所有这些研究都仅检查了基于 IFN 的治疗。25 项研究的合并估计值（95%置信区间[CI]）为持续病毒学应答（SVR）为 0.37（0.33-0.43），非 SVR 为 1.70（1.61-1.80），每 100 人年的 HCC 发生率为 1.70（1.61-1.80），发生率比（SVR 与非 SVR）为 0.22（0.19-0.26）。8 项研究调整潜在混杂因素后的 HCC 发生率的合并 HR 估计值为 0.25（0.19-0.34）。慢性丙型肝炎 IFN 治疗的 SVR 降低了 HCC 发生的风险。
