Department of Interventional Therapy, Zibo First Hospital, Zibo 255200, China.
Department of Oncology, Zibo First Hospital, Zibo 255200, China.
Cancer Epidemiol. 2023 Dec;87:102457. doi: 10.1016/j.canep.2023.102457. Epub 2023 Oct 3.
The potential role of hepatitis E virus (HEV) infection in developing hepatocellular carcinoma (HCC) is controversial and poorly investigated. We conducted a meta-analysis of observational studies to evaluate whether HEV infection increases the risk of HCC.
We searched international databases (PubMed/Medline, Web of Science Collection, Embase, and Scopus) for peer-reviewed research articles published from inception to May 1, 2023. The pooled estimates of the odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) were calculated using random-effects models. Between-study heterogeneity was measured using I² and Q-statistic. Sensitivity and cumulative analyses were performed to examine the stability of our results.
We identified seven eligible studies involving 1873 HCC cases and 8679 control subjects; the latter included 7382 healthy controls and 1297 patients with chronic liver diseases (CLD). Overall, we observed statistically significant associations between HEV infection and risk of HCC (OR 1.94; 95%CI 1.26-3.0). According to the types of the controls, the association was significant when healthy individuals were the controls (OR 2.28, 95%CI 1.43-3.64), whereas the association was not significant when the patients had CLD (OR 1.66, 95%CI 0.76-3.61). The Egger's test and funnel plot indicated that there is no publication bias (p = 0.1) in the studies included in the meta-analysis. Sensitivity and cumulative analyses also indicated stability of our results.
Our findings indicate that individuals with HEV infection had an increased risk of HCC; however, further well-designed clinical and experimental studies are needed to confirm these observations. Furthermore, whether various genotypes of HEV differ in promoting HCC also needs to be investigated.
戊型肝炎病毒（HEV）感染在肝细胞癌（HCC）发展中的潜在作用存在争议，研究甚少。我们进行了一项观察性研究的荟萃分析，以评估 HEV 感染是否会增加 HCC 的风险。
我们在国际数据库（PubMed/Medline、Web of Science 集合、Embase 和 Scopus）中搜索了自成立至 2023 年 5 月 1 日发表的同行评审研究文章。使用随机效应模型计算合并的优势比（OR）和相应的 95%置信区间（95%CI）。使用 I²和 Q 统计量来衡量研究间的异质性。进行敏感性和累积分析以检查我们结果的稳定性。
我们确定了七项符合条件的研究，涉及 1873 例 HCC 病例和 8679 例对照受试者；后者包括 7382 名健康对照者和 1297 名慢性肝病（CLD）患者。总体而言，我们观察到 HEV 感染与 HCC 风险之间存在统计学显著关联（OR 1.94；95%CI 1.26-3.0）。根据对照者的类型，当健康个体作为对照者时，相关性具有统计学意义（OR 2.28，95%CI 1.43-3.64），而当患者患有 CLD 时，相关性无统计学意义（OR 1.66，95%CI 0.76-3.61）。Egger 检验和漏斗图表明，纳入荟萃分析的研究中不存在发表偏倚（p=0.1）。敏感性和累积分析也表明我们的结果稳定。
我们的研究结果表明，HEV 感染者 HCC 的风险增加；然而，需要进一步进行精心设计的临床和实验研究来证实这些观察结果。此外，还需要研究不同基因型的 HEV 在促进 HCC 方面是否存在差异。
